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.
* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.
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.
참고문헌 (20)
1 Saiso K Adnonla P Munsil J Apipan B Rummasak D Wongsirichat N Complications associated with intravenous midazolam and fentanyl sedation in patients undergoing minor oral surgery J Dent Anesth Pain Med 2017 17 199 204 29090250
2 Tiret L Nivoche Y Hatton F Desmonts JM Vourc'h G Complications related to anaesthesia in infants and children. A prospective survey of 40240 anaesthetics Br J Anaesth 1988 61 263 269 3179147
4 An SY Seo KS Kim S Kim J Lee DW Hwang KG Developmental procedures for the clinical practice guidelines for conscious sedation in dentistry for the korean academy of dental sciences J Dent Anesth Pain Med 2016 16 253 261 28879313
5 Practice guidelines for moderate procedural sedation and analgesia 2018: A report by the american society of anesthesiologists task force on moderate procedural sedation and analgesia, the american association of oral and maxillofacial surgeons, american college of radiology, american dental association, american society of dentist anesthesiologists, and society of interventional radiology Anesthesiology 2018 128 437 479 29334501
6 Krauss B Hess DR Capnography for procedural sedation and analgesia in the emergency department Ann Emerg Med 2007 50 172 181 17222941
7 Ouchi K Fujiwara S Sugiyama K Acoustic method respiratory rate monitoring is useful in patients under intravenous anesthesia J Clin Monit Comput 2017 31 59 65 26759335
8 Chi SI Analysis on safety of and eeg change in various patient-controlled sedation methods during dental scaling (Doctoral dissertation) Seoul Seoul National University 2017
9 Itoh A Ishida A Kikuchi N Okazaki N Kuratomi Y Ishihara T Microcomputer-based respiratory function monitoring system using impedence pneumography Med Biol Eng Comput 1982 20 620 624 7176720
10 Dash S Shelley KH Silverman DG Chon KH Estimation of respiratory rate from ecg, photoplethysmogram, and piezoelectric pulse transducer signals: A comparative study of time-frequency methods IEEE Trans Biomed Eng 2010 57 1099 1107 20659821
11 Parker W Estrich CG Abt E Carrasco-Labra A Waugh JB Conway A Benefits and harms of capnography during procedures involving moderate sedation: A rapid review and meta-analysis J Am Dent Assoc 2018 149 38 50.e2 29304910
12 Mimoz O Benard T Gaucher A Frasca D Debaene B Accuracy of respiratory rate monitoring using a non-invasive acoustic method after general anaesthesia Br J Anaesth 2012 108 872 875 22323525
13 Fukada T Iwakiri H Nomura M Ozaki M Clinical evaluation of acoustic respiration rate monitoring compared with conventional systems in the postanaesthesia care unit Eur J Anaesthesiol 2015 32 61 63 25393441
14 Autet LM Frasca D Pinsard M Cancel A Rousseau L Debaene B Evaluation of acoustic respiration rate monitoring after extubation in intensive care unit patients Br J Anaesth 2014 113 195 197 24942722
15 Guechi Y Pichot A Frasca D Rayeh-Pelardy F Lardeur JY Mimoz O Assessment of noninvasive acoustic respiration rate monitoring in patients admitted to an emergency department for drug or alcoholic poisoning J Clin Monit Comput 2015 29 721 726 25614223
16 Frasca D Geraud L Charriere JM Debaene B Mimoz O Comparison of acoustic and impedance methods with mask capnometry to assess respiration rate in obese patients recovering from general anaesthesia Anaesthesia 2015 70 26 31 25040754
17 Yang S Menne A Hu P Stansbury L Gao C Dorsey N Acoustic sensor versus electrocardiographically derived respiratory rate in unstable trauma patients J Clin Monit Comput 2017 31 765 772 27270963
18 Patino M Redford DT Quigley TW Mahmoud M Kurth CD Szmuk P Accuracy of acoustic respiration rate monitoring in pediatric patients Paediatr Anaesth 2013 23 1166 1173 24033591
19 Yabuki S Toyama H Takei Y Wagatsuma T Yabuki H Yamauchi M Influences of environmental noise level and respiration rate on the accuracy of acoustic respiration rate monitoring J Clin Monit Comput 2018 32 127 132 28176048
※ AI-Helper는 부적절한 답변을 할 수 있습니다.