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01-07-2011 | Pediatric Original

A new method for continuous monitoring of chest wall movement to characterize hypoxemic episodes during HFOV

Authors: Dan Waisman, Carmit Levy, Anna Faingersh, Fatmi Ifat Colman Klotzman, Eugene Konyukhov, Irena Kessel, Avi Rotschild, Amir Landesberg

Published in: Intensive Care Medicine | Issue 7/2011

Abstract

Introduction

Monitoring ventilated infants is difficult during high-frequency oscillatory ventilation (HFOV). This study tested the possible causes of hypoxemic episodes using a new method for monitoring chest wall movement during HFOV in newborn infants.

Methods

Three miniature motion sensors were attached to both sides of the chest and to the epigastrium to measure the local tidal displacement (TDi) at each site. A >20% change in TDi was defined as deviation from baseline.

Results

Eight premature infants (postmenstrual age 30.6 ± 2.6 weeks) were monitored during 10 sessions (32.6 h) that included 21 hypoxemic events. Three types of such events were recognized: decrease in TDi that preceded hypoxemia (n = 11), simultaneous decrease in TDi and SpO₂ (n = 6), and decrease in SpO₂ without changes in TDi (n = 4). In the first group, decreases in TDi were detected 22.4 ± 18.7 min before hypoxemia, and were due to airway obstruction by secretions or decline in lung compliance. The second group resulted from apnea or severe abdominal contractions. In the third group, hypoxia appeared following a decrease in FiO₂.

Conclusions

Monitoring TDi may enable early recognition of deteriorating ventilation during HFOV that eventually leads to hypoxemia. In about half of cases, hypoxemia is not due to slowly deteriorating ventilation.

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Title: A new method for continuous monitoring of chest wall movement to characterize hypoxemic episodes during HFOV
Authors: Dan Waisman
Carmit Levy
Anna Faingersh
Fatmi Ifat Colman Klotzman
Eugene Konyukhov
Irena Kessel
Avi Rotschild
Amir Landesberg
Publication date: 01-07-2011
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 7/2011
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-011-2228-y

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A new method for continuous monitoring of chest wall movement to characterize hypoxemic episodes during HFOV

Abstract

Introduction

Methods

Results

Conclusions

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Abstract

Introduction

Methods

Results

Conclusions

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