Background: Respiration monitoring is necessary during sedation for dental treatment. Recently, acoustic respiration rate ($RRa^{TM}$), an acoustics-based respiration monitoring method, has been used in addition to auscultation or capnography. The accuracy of this method may be compromise...
Background: Respiration monitoring is necessary during sedation for dental treatment. Recently, acoustic respiration rate ($RRa^{TM}$), an acoustics-based respiration monitoring method, has been used in addition to auscultation or capnography. The accuracy of this method may be compromised in an environment with excessive noise. This study evaluated whether noise from the ultrasonic scaler affects the performance of RRa in respiratory rate measurement. Methods: We analyzed data from 49 volunteers who underwent scaling under intravenous sedation. Clinical tests were divided into preparation, sedation, and scaling periods; respiratory rate was measured at 2-s intervals for 3 min in each period. Missing values ratios of the RRa during each period were measuerd; correlation analysis and Bland-Altman analysis were performed on respiratory rates measured by RRa and capnogram. Results: Respective missing values ratio from RRa were 5.62%, 8.03%, and 23.95% in the preparation, sedation, and scaling periods, indicating an increased missing values ratio in the scaling period (P < 0.001). Correlation coefficients of the respiratory rate, measured with two different methods, were 0.692, 0.677, and 0.562 in each respective period. Mean capnography-RRa biases in Bland-Altman analyses were -0.03, -0.27, and -0.61 in each respective period (P < 0.001); limits of agreement were -4.84-4.45, -4.89-4.15, and -6.18-4.95 (P < 0.001). Conclusions: The probability of missing respiratory rate values was higher during scaling when RRa was used for measurement. Therefore, the use of RRa alone for respiration monitoring during ultrasonic scaling may not be safe.
Background: Respiration monitoring is necessary during sedation for dental treatment. Recently, acoustic respiration rate ($RRa^{TM}$), an acoustics-based respiration monitoring method, has been used in addition to auscultation or capnography. The accuracy of this method may be compromised in an environment with excessive noise. This study evaluated whether noise from the ultrasonic scaler affects the performance of RRa in respiratory rate measurement. Methods: We analyzed data from 49 volunteers who underwent scaling under intravenous sedation. Clinical tests were divided into preparation, sedation, and scaling periods; respiratory rate was measured at 2-s intervals for 3 min in each period. Missing values ratios of the RRa during each period were measuerd; correlation analysis and Bland-Altman analysis were performed on respiratory rates measured by RRa and capnogram. Results: Respective missing values ratio from RRa were 5.62%, 8.03%, and 23.95% in the preparation, sedation, and scaling periods, indicating an increased missing values ratio in the scaling period (P < 0.001). Correlation coefficients of the respiratory rate, measured with two different methods, were 0.692, 0.677, and 0.562 in each respective period. Mean capnography-RRa biases in Bland-Altman analyses were -0.03, -0.27, and -0.61 in each respective period (P < 0.001); limits of agreement were -4.84-4.45, -4.89-4.15, and -6.18-4.95 (P < 0.001). Conclusions: The probability of missing respiratory rate values was higher during scaling when RRa was used for measurement. Therefore, the use of RRa alone for respiration monitoring during ultrasonic scaling may not be safe.
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문제 정의
An ultrasonic scaler, a commonly used device in dental practice, causes vibration and noise that may affect the accuracy of the acoustic respiration monitoring device. This study aimed to evaluate the effect of noise from the ultrasonic scaler on RRa respiration monitoring.
제안 방법
The clinical monitoring in this study was divided into preparation, sedation, and scaling periods. Only monitoring was performed without sedative administration during the preparation period.
Respiratory rate over 3 min from each period were extracted from stored data for this analysis. Three sets of data, 3-min in length, were collected from the following periods: immediately before drug administration in the preparation period, at 5 min after the start of drug administration in the sedation period, and at the time of the initialization of the use of scaler in the scaling period.
대상 데이터
After the extraction and review of data from 60 subjects, 49 subjects with confirmed respiration on capnogram wave were included in the analysis. The average age of the subjects was 26.
Ninety samples were collected over 3 min from each subject and period, totaling 13,230 samples from 49 subjects. Respiratory rates by period are shown in Table 1.
0 kg. Thirty-five subjects were male and 14 were female.
This study used data from a previous study on patientcontrolled sedation, approved by the Seoul National University IRB (the clinical research information service [CRiS], Republic of Korea [https://cris.nih.go.kr/cris/index.jsp], registration number KCT0001618) [8]. Sixty adult volunteers, 20–60 years of age, with American Society of Anesthesiologists statuses of I or II, were allocated to propofol and midazolam groups.
데이터처리
Means and standard deviations of the respiratory rates measured with the two devices over the three periods were calculated; the probabilities of missing values were compared with chi-squared test. Respiratory rates measured by RRa and capnography in each period were analyzed for correspondence by using correlation coefficient and Bland-Altman analysis.
Means and standard deviations of the respiratory rates measured with the two devices over the three periods were calculated; the probabilities of missing values were compared with chi-squared test. Respiratory rates measured by RRa and capnography in each period were analyzed for correspondence by using correlation coefficient and Bland-Altman analysis. P < 0.
후속연구
Subjects who exhibited oral respiration were also excluded from analysis, since the accuracy of respiration could not be confirmed. Further studies are needed regarding the cause of missing values, as well as regarding accuracy during apnea or oral respiration.
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