DPOP is a measure of the strength of respiratory modulations present in the pulse oximetry photoplethysmogram (pleth) waveform. It has been proposed as a non-invasive parameter for the prediction of the response to volume expansion in hypovolemic patients. The effect of resistive breathing on the DPOP parameter was studied to determine whether it may have an adjunct use as a measure of respiratory effort. Healthy volunteers were tasked to breathe at fixed respiratory rates over a range of airway resistances generated by a flow resistor inserted within a mouthpiece. Changes in respiratory efforts, effected by the subjects and measured as airway pressures at the mouth, were compared to DPOP values derived from a finger pulse oximeter probe. It was found that the increased effort to breathe manifests itself as an associated increase in DPOP. Further, a relationship between DPOP and percent modulation of the pleth waveform was observed. A version of the DPOP algorithm that corrects for low perfusion was implemented which resulted in an improved relationship between DPOP and PPV. Although a limited cohort of seven volunteers was used, the results suggest that DPOP may be useful as a respiratory effort parameter, given that the fluid level of the patient is maintained at a constant level over the period of analysis.
Rapoport DM. Non-invasive detection of respiratory effort-related arousals (RERAs) by a nasal cannula/pressure transducer system. Sleep. 2000;23(6):763. PubMed
Brock J, Pitson D, Stradling J. Use of pluse transit time as a measure of changes in inspiratory effort. J Ambul Monit. 1993;6(4):295–302.
Pagani J, Villa MP, Calcagnini G, Alterio A, Ambrosio R, Censi F, Ronchetti R. Pulse transit time as a measure of inspiratory effort in children. CHEST J. 2003;124(4):1487–93. CrossRef
Mañanas MA, Alonso JF, Topor ZL, Bruce EN, Houtz P, Caminal P. Frequency parameters from myographic signals for the evaluation of respiratory muscle activity during an increased ventilatory effort. In: Engineering in Medicine and Biology Society, 2003. Proceedings of the 25th annual international conference of the IEEE 2003; 4:3203–3206.
Ertin E, Stohs N, Kumar S, Raij A, al’Absi M, Shah S. AutoSense: unobtrusively wearable sensor suite for inferring the onset, causality, and consequences of stress in the field. In: Proceedings of the 9th ACM conference on embedded networked sensor systems. ACM; 2011. pp. 274–287.
Matecki S, Milesie C, Baleine J, Jacquot A, Cambonie G. Effect of high-flow nasal cannula on nasopharyngeal airway pressure, respiratory muscles loading and respiratory distress symptoms in young infants with severe acute viral bronchiolitis. Eur Respir J. 2012;40(Suppl 56):P1071.
Sepeku A, Kohi TW. Treatment outcomes of neonatal asphyxia at a national hospital in Dar es Salaam, Tanzania. Afr J Nurs Midwifery. 2011;13(2):43–56.
Nakano H, Hayashi M, Ohshima E, Nishikata N, Shinohara T. Validation of a new system of tracheal sound analysis for the diagnosis of sleep apnea-hypopnea syndrome. Sleep. 2004;27(5):951–8. PubMed
Addison PS, Watson JN, Mestek ML, Ochs JP, Uribe AA, Bergese SD. Pulse oximetry-derived respiratory rate in general care floor patients. J Clin Monit Comput. 2014;29(1):113–120.
Hartert TV, Wheeler AP, Sheller JR. Use of pulse oximetry to recognize severity of airflow obstruction in obstructive airway disease: correlation with pulsus paradoxus. CHEST J. 1999;115(2):475–81. CrossRef
Addison PS, Watson JN, Ochs JP, Neitenbach AM, Mestek ML. Flexible pulse oximeter probe design for monitoring respiration parameters: a feasibility demonstration. In: IAMPOV symposium, Yale University, New Haven, CT, 29 June–1 July 2012, Program Syllabus, 2012; pp. 40–41. (keep for now but could replace with A&A paper on resp effort from pleth just submitted).
Cannesson M, Besnard C, Durand PG, Bohe J, Jacques D. Relation between respiratory variations in pulse oximetry plethysmographic amplitude and arterial pulse pressure in ventilated patients. Crit Care. 2005;9(5):562–8. CrossRef
Monnet X, Teboul JL. Assessment of volume responsiveness during mechanical ventilation: recent advances. Crit Care. 2013;17:R217. CrossRef
Addison PS, Wang R, McGonigle SJ, Uribe AA, Bergese SD. Calculation of the respiratory modulation of the photoplethysmogram (DPOP) incorporating a correction for low perfusion. Anesthesiol Res Pract. 2014.
- Respiratory modulations in the photoplethysmogram (DPOP) as a measure of respiratory effort
Paul S. Addison
- Springer Netherlands
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