Prospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Jul 18, 2019; 10(3): 57-66
Published online Jul 18, 2019. doi: 10.4292/wjgpt.v10.i3.57
Novel device for monitoring respiratory rate during endoscopy-A thermodynamic sensor
Vaibhav Wadhwa, Adalberto J Gonzalez, Kristen Selema, Ronen Feldman, Rocio Lopez, John J Vargo
Vaibhav Wadhwa, Adalberto J Gonzalez, Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL 33324, United States
Kristen Selema, Department of Internal Medicine, Cleveland Clinic Florida, Weston, FL 33331, United States
Ronen Feldman, Department of Technology, Artep Incorporated, Elliot City, MD 21042, United States
Rocio Lopez, Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH 44195, United States
John J Vargo, Department of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: Wadhwa V, Vargo JJ, and Feldman R designed the study; Lopez R analyzed the data; Wadhwa V, Gonzalez AJ, and Selema K wrote the paper; Vargo JJ revised the manuscript for final submission.
Institutional review board statement: The study was reviewed and approved by the Cleveland Clinic Foundation Institutional Review Board.
Clinical trial registration statement: The study did not undergo clinical trial registration, as the Institutional Review Board did not require it.
Informed consent statement: Informed consent was obtained from all the subjects that participated in this study.
Conflict-of-interest statement: Ronen Feldman has a financial interest in Linshom.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: John J Vargo, MD, MPH, Department of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States. vargoj@ccf.org
Telephone: +1-216-4446521 Fax: +1-216-4446284
Received: February 3, 2019
Peer-review started: February 6, 2019
First decision: March 5, 2019
Revised: March 19, 2019
Accepted: April 8, 2019
Article in press: April 9, 2019
Published online: July 18, 2019
Abstract
BACKGROUND

Monitoring ventilation accurately is an indispensable aspect of patient care in procedural settings. The current gold standard method of monitoring ventilation is by measuring exhaled carbon dioxide concentration, known as capnography. A new device utilizing thermodynamic measurement, the Linshom Respiratory Monitoring Device (LRMD), has been designed to measure respiratory rate (RR) by using the temperature of exhaled breath. We hypothesized that the temperature sensor is at least equivalent in accuracy to capnography in monitoring ventilation.

AIM

To determine if the temperature sensor is equivalent to capnography in monitoring procedural ventilation.

METHODS

In this prospective study, participants were individually fitted with a face mask monitored by both LRMD and capnography. The following data were collected: gender, age, body mass index, type of procedure, and doses of medication. For each patient, we report the mean RR for each device as well as the mean difference. All analyses were performed using SAS, and a P < 0.05 was considered statistically significant.

RESULTS

Twelve consecutive patients undergoing endoscopic procedures at our institution were enrolled. Four patients were excluded due to incomplete data, inadequate data, patient cooperation, and capnography failure. Overall, we found that LRMD RR highly correlated to capnography RR (P < 0.001); the average capnography RR increases by 0.66 breaths for every one additional breath measured by the LRMD. In addition, apnea rates were 7.4% for the capnography and 6.4% for the LRMD (95% confidence interval: 0.92-1.10).

CONCLUSION

The LRMD correlated with the gold standard capnography with respect to respiratory rate detection and apnea events. The LRMD could be used as an alternative to capnography for measuring respiration in endoscopy.

Keywords: Sedation, Capnography, Linshom, Thermodynamic sensor, Endoscopy

Core tip: The current gold standard method of monitoring ventilation during procedures is capnography. A new device utilizing a thermodynamic measurement, Linshom Respiratory Monitoring Device (LRMD) has been designed to measure respiratory rate by using the temperature of exhaled breath. This study showed that the LRMD correlated with the gold standard capnography with respect to respiratory rate detection and apnea events. The LRMD could be used as an alternative to capnography for measuring respiration in endoscopy.