Use of a novel non-invasive respiratory monitor to study changes in pulmonary ventilation during labor epidural analgesia

Autor: Arvind Palanisamy, Anton Chau, Lawrence C. Tsen, Lynn Choi, Brian C Harvey, Jordan Brayanov, Bhavani Shankar Kodali
Rok vydání: 2019
Předmět:
Zdroj: Journal of Clinical Monitoring and Computing. 34:567-574
ISSN: 1573-2614
1387-1307
DOI: 10.1007/s10877-019-00349-1
Popis: Measuring continuous changes in maternal ventilation during labor neuraxial analgesia is technically difficult. Consequently, the magnitude of pulmonary minute ventilation (MV) alterations following labor analgesia remains unknown. We hypothesized that a novel, bio-impedance based non-invasive respiratory monitor would provide this information. Furthermore, we sought to determine if an association between changes in MV and maternal temperature existed. Following calibration with a Haloscale Standard Wright Respirometer, the ExSpiron respiratory volume monitor (RVM) measured MV, respiratory rate (RR), and tidal volume (TV) in 41 term parturients receiving epidural analgesia. Simultaneously, maternal oral temperatures were recorded at pre-specified hourly intervals after epidural analgesia initiation until delivery. Cumulative MV changes were calculated as the integral of MV change over time: MV $$\left( {\mathop \smallint \limits_{0}^{T} \Delta MV dt} \right)$$, where T represents the time between epidural placement and variable measurement. The association between changes in MV and cumulative MV versus maternal temperature was determined by comparing patients whose temperature did or did not increase by ≥ 0.5 °C. After initiation of epidural analgesia, MV decreased by 11.1 ± 27.6% [mean ± SD] at 30 min, p = 0.006, and 19.8 ± 26.1% at 2 h compared to baseline (12.6 ± 7.3 L/min at baseline vs. 15.3 ± 6.3 L/min at 2 h, p
Databáze: OpenAIRE
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