An open-source software for automatic calculation of respiratory parameters based on esophageal pressure

Area of Science:

• Respiratory Physiology
• Medical Software Development
• Critical Care Medicine

Background:

• Accurate assessment of respiratory effort is crucial for mechanical ventilation management.
• Manual calculation of respiratory effort indices can be time-consuming and prone to variability.
• Intrinsic positive end-expiratory pressure (PEEPi) and esophageal pressure-time product (PTPeso) are key indicators of respiratory workload.

Purpose of the Study:

• To develop and validate a software tool for automatic calculation of respiratory effort indices.
• To provide a reliable and efficient method for quantifying PEEPi and PTPeso.
• To facilitate the integration of these measurements into routine clinical practice.

Main Methods:

• Developed software to automatically identify respiratory periods and extract parameters.
• Utilized an algorithm to detect the onset of inspiratory effort via esophageal pressure derivative.
• Analyzed 23 patient recordings, comparing automated results with expert manual analysis.

Main Results:

• The software demonstrated high accuracy, with coefficients of determination (r²) exceeding 0.94 for all calculated values.
• Automated PEEPi calculation showed minimal bias (-0.26±0.52 cmH2O) and high precision during spontaneous breathing.
• Automated PTPeso calculation also exhibited low bias (-0.38±1.42 cmH2Os/cycle) and good agreement with manual analysis.

Conclusions:

• The developed software offers a reliable method for automatic calculation of PEEPi and other respiratory effort indices.
• This automation can significantly aid clinicians in utilizing these important respiratory variables.
• The open-source nature of the software allows for future improvements and the addition of new parameters.