One of the most important indicators of a patient’s medical status is – quite simply – the way he or she breathes. During and after surgery, physicians closely monitor the rate by which air passes in and out of the lungs. Good breath flow is a good sign. Irregular or noisy breathing can raise a serious red flag.
For instance, an increasing respiratory rate can be an early warning sign of a major adverse event, such as developing sepsis. A decreasing respiratory rate may indicate opioids-induced respiratory depression.
Now, researchers think they may have identified a device that can expand this monitoring to patients in the recovery ward and raise those red flags much earlier. That device – the mere size of a small Band-Aid – could also soon add to the safety of patients admitted to the hospital.
Results of a new clinical study, spearheaded by the president of Baylor Research Institute (BRI), recently appeared in Anesthesia and Analgesia, the flagship scientific journal for the International Anesthesia Research Society.
Together with his team, Dr. Michael Ramsay reviewed the effectiveness of an acoustic respiratory rate monitor, a tool that measures a patient’s breathing through sound. The small device, placed on the patient’s neck, is equipped with acoustic technology that translates respiratory sounds into an electronic signal. It is basically a digital stethoscope that can transmit breath sounds to a remote monitor.
The study was conducted to see how the new device stacked up to the current technology for respiration monitoring in accuracy, precision and reliability.
“Existing technology that measures exhaled carbon dioxide (capnometer) is placed in a very sensitive area under the nose, is frequently dislodged and is not wireless,” Dr. Ramsay said. “It is uncomfortable and not secure. The signal displayed may go up or down with hypoventilation depending on whether the patient is taking slow deep breaths or shallow breaths. Shallow breathing does not cause adequate alveolar gas exchange and therefore does not reflect the true carbon dioxide level in the lungs.”
The new device, he said, measures respiratory rate – an important component of ventilation – and displays the quality of the breath sound. It is unobtrusive to the patient and wireless.
Throughout the study, researchers monitored 33 post-surgical adults that were connected to both an acoustic monitor and a capnometer. The team found that while both devices were reliable, the acoustic technology was statistically more accurate and precise than the capnometer . While their performance differences were modest, the accuracy of the acoustic sensor was proven as a reliable form of respiratory recording technology.
Among their findings, the team saw that the acoustic device accurately recorded breath rate both automatically and continually.
“That’s the key,” Dr. Ramsay said. “Having continuous respiratory records is vital, because with enhanced breath monitors, physicians could potentially be alerted when a patient’s condition worsens.”
Plus, since the device is positioned on the neck, where it can serve as a steady monitor (rather than inserted into a patient’s nasal tubes, where it could be dislodged) the monitor enhances patient comfort.
“All patients who receive intravenous opioids after surgery are at risk for respiratory depression. Some patients have a very high risk because of co-morbid conditions such as sleep apnea. This type of unobtrusive technology will allow continual monitoring and perhaps more importantly close the loop between the nurse and the patient by automatically alerting the nurse if there is a deterioration in the patient,” Dr. Ramsay said. “In other words: the monitor is always being monitored.”
Contact:
Kristine Hughes
kristine.hughes@baylorhealth.edu
214.820.7556
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As the largest not-for-profit health system in the state of Texas, Baylor Scott & White promotes the health and well-being of every individual, family and community it serves. It is committed to making quality care more accessible, convenient and affordable through its integrated delivery network, which includes the Baylor Scott & White Health Plan, Baylor Scott & White Research Institute, the Baylor Scott & White Quality Alliance and its leading digital health platform – MyBSWHealth. Through 51 hospitals and more than 1,200 access points, including flagship academic medical centers in Dallas, Fort Worth and Temple, the system offers the full continuum of care, from primary to award-winning specialty care. Founded as a Christian ministry of healing more than a century ago, Baylor Scott & White today serves more than three million Texans. For more information, visit: BSWHealth.com