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Radar-based breathing rate monitoring: manikin + human volunteer study. Dave Parry 1 Gary Smith 2 Sheena Farrell 2 David Prytherch 2 Nicholas Hirsch 3 Sarah Harrison 2 Lynsey Woodward 2 University of Portsmouth 1 Portsmouth Hospitals NHS Trust 2

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slide1

Radar-based breathing rate monitoring:

manikin + human volunteer study

Dave Parry 1

Gary Smith 2

Sheena Farrell 2

David Prytherch 2

Nicholas Hirsch 3

Sarah Harrison 2

Lynsey Woodward 2

University of Portsmouth 1

Portsmouth Hospitals NHS Trust 2

National Hospital for Neurology & Neurosurgery 3

slide2

Breathing rate

  • should be routine component of clinical monitoring
  • is difficult to measure
  • affected by many clinical states
  • important predictor of cardiopulmonary arrest, death and readmission to a critical care unit
  • importance and usefulness often underestimated by clinicians
  • poor level of breathing rate recording in general hospital wards
slide3

30

continuous monitoring

20

10

Nurse

Nurse

Potential benefits of continuous monitoring of breathing rate

Breathing rate

Time

slide5

Laerdal BedAlert

  • device development funded by Laerdal Medical
  • resources provided by Laerdal Medical
  • research undertaken jointly by Portsmouth Hospitals NHS Trust and University of Portsmouth
slide7

Radar head unit

Network cable

1.7 metres

PC Controller

Laerdal BedAlert: arrangement of study components

slide8

Laerdal BedAlert: manikin study

  • simulation study
  • breathing rate recorded by the BedAlert vs that of an intubated, human manikin lying supine on a standard bed, ventilated using a positive pressure ventilator
  • measurements were taken at ventilator tidal volumes 150-950 mls
  • manikin breathing rates varied from 5 to 45 breaths/minute in steps of 5 breaths/minute
  • each manikin breathing rate kept constant for 5 minutes
  • average value of the BedAlert breathing rate recorded
slide9

Laerdal BedAlert: manikin study

n = 52

BedAlert

breathing

rate (bpm)

Manikin breathing rate (bpm)

slide10

Ventilator-driven manikin breathing rate

Laerdal BedAlert: manikin study

Bland Altman plot of results for all tidal volumes combined

Manikin – BedAlert breathing rate

Mean difference (bias) = 0.899 bpm

SD of the difference (precision) = 0.873

Limits of agreement = +2.61 to -0.812 bpm

slide12

Laerdal BedAlert: manikin study

  • the BedAlert radar system gives a clinically acceptable agreement in breathing rate with that of a ventilator-driven human manikin.
  • no obvious influence of tidal volume on measured breathing rate
  • in 2002 Lim et al showed inter and intra-observer limits of agreement of +4.4 to -4.2 breaths per minute (experienced clinical staff vs experienced clinical staff).
slide14

Laerdal BedAlert: human volunteer study

  • 6 human volunteers
  • computer metronome played repetitive tone at set rate
  • tone rate 5 – 35 breaths/minute
  • tone maintained for 2 minutes at each stage
  • breathing rate simultaneously recorded by BedAlert.
  • studied in 4 different positions
slide15

Radar head unit

Network cable

1.7 metres

PC Controller

Laerdal BedAlert: arrangement of study components

slide16

Laerdal BedAlert: human volunteer study

n = 2105

Tone

rate (bpm)

BedAlert breathing rate (bpm)

slide17

Laerdal BedAlert: human volunteer study

Tone rate – BedAlert breathing rate

Mean difference (bias) = 0.010 bpm

SD off the difference (precision) = 0.348

Limits of agreement = +0.692 to -0.672 bpm

Bland Altman plot of results for all positions

slide18

Laerdal BedAlert: human volunteer study

Bias, precision and limits of agreement for the positions studied

slide19

Laerdal BedAlert: summary

  • accurate
  • painless
  • non-invasive
  • safe
  • radar-based method of measuring breathing rate
  • potential benefits of continuous monitoring
  • requires minimal human resources
  • next steps