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Combining Volumetric Capnography And Barometric Plethysmography To Measure The Lung Structure-function Relationship

Combining Volumetric Capnography And Barometric Plethysmography To Measure The Lung Structure-function Relationship

Published on: January 8, 2019

Investigating the clinical use of structured light plethysmography to assess lung function in children with

Deborah Fleck¹, Chistopher Curry², Kate Donnan²

¹Nursing and Health Research Institute, School of Health Sciences, Ulster University, Belfast, Northern Ireland, United Kingdom.

|August 27, 2019

Insights

Structured Light Plethysmography (SLP) offers a novel, non-contact method for monitoring respiratory function in children with neuromuscular disorders (NMD). This technique shows promise for assessing lung function with limited patient cooperation, aiding in timely interventions for NMD patients.

Area of Science:

Pulmonary Medicine
Biomedical Engineering
Pediatric Respiratory Health

Background:

Children with neuromuscular disorders (NMD), including Duchenne Muscular Dystrophy (DMD), experience progressive respiratory muscle weakness and pulmonary restriction.
Monitoring pulmonary function is crucial for timely interventions like cough assist and non-invasive ventilation (NIV).
Traditional lung function measurements can be challenging for NMD patients.

Purpose of the Study:

To investigate Structured Light Plethysmography (SLP) as a novel, non-contact method for monitoring respiratory function in children with NMD.
To assess the feasibility and effectiveness of SLP in pediatric NMD populations.

Main Methods:

Correlated SLP thoraco-abdominal (TA) displacement with spirometry-measured forced vital capacity (FVC).
Examined the repeatability of measurements using both SLP and spirometry.
Investigated SLP tidal breathing parameters, including regional TA displacement and rib cage/abdominal wall motion.

Main Results:

SLP and spirometry showed good correlation (R=0.78) for FVC but poor measurement agreement.
SLP demonstrated good repeatability in healthy controls and moderate repeatability in NMD children.
SLP identified age-related reductions in abdominal contribution and detected paradoxical breathing in DMD patients, revealing distinct breathing patterns.

Conclusions:

SLP is a promising novel method for lung function assessment in children with NMD, requiring minimal cooperation.
SLP provides detailed insights into chest wall and abdominal movement contributions.
This technique may enhance respiratory monitoring and management for pediatric NMD patients.

Read full analysis

Abstract

Background:

Children and young people with neuromuscular disorders (NMD), such as Duchenne Muscular Dystrophy (DMD), develop progressive respiratory muscles weakness and pulmonary restriction. Pulmonary function monitoring of the decline in lung function allows for timely intervention with cough assist techniques and nocturnal non-invasive ventilation (NIV). NMD may find the measurement of lung function difficult using current techniques. Structured Light Plethysmography (SLP) has been proposed as a novel, non-contact, self-calibrating, non-invasive method of assessing lung function. The overarching aim of this study was to investigate the use of SLP as a novel method for monitoring respiratory function in children with neuromuscular disease.

Methods:

SLP thoraco-abdominal (TA) displacement was correlated with forced vital capacity measurements recorded by spirometry and the repeatability of the measurements with both methods examined. SLP tidal breathing parameters were investigated to assess the range and repeatability of regional right and left side TA displacement and rib cage and abdominal wall displacement.

Results:

The comparison of the FVC measured with SLP and with spirometry, while having good correlation (R = 0.78) had poor measurement agreement (95% limits of agreement: -1.2 to 1.2L) The mean relative contribution of right and left TA displacement in healthy controls was 50:50 with a narrow range. Repeatability of this measure with SLP was found to be good in healthy controls and moderate in NMD children with/without scoliosis but with a wider range. The majority of the control group displayed a predominant rib cage displacement during tidal breathing and those who displayed predominant abdominal wall displacement showed displacement of both regions close to 50:50 with similar results for the rib cage and abdomen. In comparison, children with NMD have a more variable contribution for all of these parameters. In addition, SLP was able to detect a reduction in abdominal contribution to TA displacement with age in the DMD group and detect paradoxical breathing in children with NMD. Using SLP tracings during tidal breathing we were able to identify three specific patterns of breathing amongst healthy individuals and in children with NMD.

Conclusions:

SLP is a novel method for measuring lung function that requires limited patient cooperation and may be especially useful in children with neuromuscular disorders. Measuring the relative contributions of the right and left chest wall and chest versus abdominal movements allows a more detailed assessment.

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