Presented at the 2012 AAPM Annual Meeting « Back

Assessment of a Noninvasive, Real-Time Respiratory Monitor to Be Used in the Management of Pain

Jenny E. Freeman, MD, jenny.freeman@respiratorymotion.com¹, Michael J. Lalli, BS¹, Nicole D. Yocum, MA¹, Alexander Panasyuk, PhD¹, Svetlana Panasyuk, PhD¹, Robert Lew, PhD¹, (1) Respiratory Motion, Inc., Waltham, Massachusetts

Introduction: Postoperative analgesic titration is a fine balance between patient comfort and respiratory failure. Existing respiratory indicators fail to provide accurate, time-sensitive assessments. A novel Respiratory Variation Monitor (RVM) continuously tracks minute ventilation, tidal volume, and respiratory rate in real time promoting effective management of pain and improved patient safety. Methods: A diverse cohort consisted of 96 subjects (306 visits, 7226 tests, age 19–84, BMI 16.4-50.9). Using an impedance-based RVM created with adaptive electronics and specific electrode placement, dual channel RVM data were collected simultaneously with spirometry data during normal and erratic breathing and compared to evaluate accuracy and precision of RVM tidal volume, respiratory rate, and minute ventilation measurements. Results: RVM data correlated strongly with spirometric volume data, with median correlation across all subjects of r = 0.98 for normal breathing and r = 0.96 for erratic breathing. A mixed effects ANOVA analysis (subject is a random effect) discriminated (p < 0.001) for dual versus single lead placements. RVM data was found adequate for advanced analysis of respiratory curve parameters and complexity. Conclusions: RVM data can accurately determine tidal volume, respiratory rate, and minute ventilation and projects to have utility in pain and opioid management in patients at risk for respiratory depression. Offering clinical applicability as a turn-key, cost-effective tool, RVM has the potential to become a new standard of care, both increasing patient safety and decreasing cost of care.

Funding: None