DOCSLIB.ORG

The Heterogeneity of Obstructive Sleep Apnea (Predominant Obstructive Vs Pure Obstructive Apnea) Ailiang Xie, Phd2,3; Ajay Bedekar, MD1; James B

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Heterogeneity of Obstructive Sleep Apnea (Predominant Obstructive Vs Pure Obstructive Apnea) Ailiang Xie, Phd2,3; Ajay Bedekar, MD1; James B PREDOMINANT OBSTRUCTIVE VERSUS PURE OBSTRUCTIVE APNEA 10.5665/SLEEP.1040 The Heterogeneity of Obstructive Sleep Apnea (Predominant Obstructive vs Pure Obstructive Apnea) Ailiang Xie, PhD2,3; Ajay Bedekar, MD1; James B. Skatrud, MD*1,3; Mihaela Teodorescu, MD1,3; Yuansheng Gong, PhD1; Jerome A. Dempsey, PhD2 1Department of Medicine, 2Population Health Sciences, University of Wisconsin, Madison, WI; 3Middleton Memorial Veterans Hospital, Madison, WI Study Objectives: To compare the breathing instability and upper airway collapsibility between patients with pure OSA (i.e. 100% of apneas are obstructive) and patients with predominant OSA (i.e., coexisting obstructive and central apneas). Design: A cross-sectional study with data scored by a fellow being blinded to the subjects’ classification. The results were compared between the 2 groups with unpaired student t-test. Downloaded from https://academic.oup.com/sleep/article/34/6/745/2656968 by guest on 24 September 2021 Setting and interventions: Standard polysomnography technique was used to document sleep-wake state. Ventilator in pressure support mode was used to introduce hypocapnic apnea during CO2 reserve measurement. CPAP with both positive and negative pressures was used to produce obstructive apnea during upper airway collapsibility measurement. Participants: 21 patients with OSA: 12 with coexisting central/mixed apneas and hypopneas (28% ± 6% of total), and 9 had pure OSA. Measurements: The upper airway collapsibility was measured by assessing the critical closing pressure (Pcrit). Breathing stability was assessed by measuring CO2 reserve (i.e., ∆PCO2 [eupnea-apnea threshold]) during NREM sleep. Results: There was no difference in Pcrit between the 2 groups (pure OSA vs. predominant OSA: 2.0 ± 0.4 vs. 2.7 ± 0.4 cm H2O, P = 0.27); but the CO2 reserve was significantly smaller in predominant OSA group (1.6 ± 0.7 mm Hg) than the pure OSA group (3.8 ± 0.6 mm Hg) (P = 0.02). Conclusions: The present data indicate that breathing stability rather than upper airway collapsibility distinguishes OSA patients with a combina- tion of obstructive and central events from those with pure OSA. Keywords: CO2 reserve, Pcrit, OSA Citation: Xie A; Bedekar A; Skatrud JB; Teodorescu M; Gong Y; Dempsey JA. The heterogeneity of obstructive sleep apnea ���������������������(predominant obstruc- tive vs pure obstructive apnea). SLEEP 2011;34(6):745-750. INTRODUCTION and respiratory control instability.2,6 On the other hand, when Since obstructive sleep apnea (OSA) is characterized by fu- the central respiratory output drops to zero, central apnea (CA) tile respiratory efforts against a closed upper airway, patients occurs regardless of UAW structural and functional status. It is with OSA are believed to have anatomical/functional deficits very likely that the phenotype of sleep apnea (CA vs. OA) is in the upper airway (UAW). However, patients very rarely shaped by the interaction of respiratory drive and UAW resis- present with pure OSA in clinical practice, with most OSA tance. We therefore hypothesized that for patients with equally patients exhibiting some proportion of central and/or mixed severe OSA, those with pure OSA have a more collapsible air- events. It is not clear why both types of apnea occur in the way than those with coexisting obstructive and central apneas same individual during the same night, but the coexistence of (predominant OSA); while the predominant OSA group have two types of apnea indicates more complicated underlying dis- more significant instability of the respiratory system than the orders than increased UAW resistance alone. In fact, unstable pure OSA group. To test this hypothesis, we measured CO2 breathing control has been implicated in the pathogenesis of reserve (i.e., ∆PCO2 [eupnea- apneic threshold]) to approxi- both central and obstructive sleep apnea. Some patients with mate the breathing propensity for instability and UAW critical OSA exhibit evidence of unstable ventilatory control (i.e., in- closing pressure (Pcrit) to assess the UAW collapsibility in pa- creased control system “loop gain,”) that could contribute to tients with OSA, and compared these 2 indexes between the 2 UAW narrowing and obstruction.1,2 We have noticed that ob- subgroups (pure OSA vs. predominant OSA). structive apnea (OA) begins at the nadir of respiratory drive,3 and that superimposing an unstable respiratory motor output METHODS precipitated airway obstruction during sleep in snoring sub- jects.4 We have also observed that increasing chemoreceptor Subjects stimulation (via increased inhalation of CO2) reduced UAW We studied 21 patients with OSA diagnosed via overnight resistance in sleeping subjects.5 Hence the occurrence of OA polysomnography (i.e. all patients had an apnea/hypopnea index appears to involve aspects of both upper airway collapsibility [AHI] > 10/h of sleep time). Of the apneas, ≥ 50% were classi- fied as obstructive in nature. Among these 21 subjects, 9 pre- sented with pure OSA (100% of apneas were obstructive) and Submitted for publication September, 2010 12 with predominant OSA (100% > obstructive apneas > 50%). Submitted in final revised form January, 2011 Subjects were excluded if they had chronic obstructive pulmo- Accepted for publication February, 2011 nary disease/asthma, concomitant medical illness such as renal/ *James Skatrud is deceased. liver dysfunction, or other confounding sleep disorders. All Address correspondence to: Ailiang Xie, MD, PhD, Pulmonary Physiology subjects provided informed consent prior to participation. The Laboratory, VA Hospital, 2500 Overlook Terrace, Madison, WI 53705; Tel: experimental protocol was approved by the University of Wis- (608) 256-1901, ext. 17544; Fax: (608) 280-7009; E-mail: [email protected] consin Center for Health Sciences Human Subjects Committee. SLEEP, Vol. 34, No. 6, 2011 745 Predominant Obstructive vs Pure Obstructive Apnea—Xie et al positive airway pressure (CPAP) to eliminate airway obstruction Table 1—Subject description and stabilize breathing. Then we administrated pressure support Pure OSA Predominant ventilation in a step-wise fashion by increasing the pressure by 2 group OSA group P-value cm H2O every 1 min until apnea and periodic breathing occurred. Number 9 (2 F + 7 M) 12 (1 F + 11 M) N/A et We confirmed this apneic threshold P CO2 by abruptly increas- Age, y 50.6 ± 3.8 54.1 ± 2.6 0.40 ing pressure to the previously determined level in one step. BMI, kg/m2 36.8 ± 2.8 34.3 ± 1.7 0.43 AHI, events/h 49.2 ± 9.4 47.1 ± 10.4 0.89 Upper Airway Critical Closing Pressure (Pcrit) AHI in NREM, events/h 45.9 ± 9.3 45.7 ± 9.4 0.75 Measurements of Pcrit were performed in a standard supine AHI in REM, events/h 57.0 ± 13.1 50.2 ± 16.3 0.77 posture with the head positioned in a contoured pillow to as- AHI in supine, events/h 51.4 ± 12.2 61.6 ± 16.1 0.64 sure a constant position. During stable NREM sleep, CPAP Obstructive apnea 27.7 ± 14.4 21.5 ± 7.0 0.67 was increased by 2 cm H2O every 1 min until flow limitation (% of total AH events) was eliminated, and this holding pressure was then maintained Downloaded from https://academic.oup.com/sleep/article/34/6/745/2656968 by guest on 24 September 2021 Central apnea 0 ± 0 11.4 ± 6.3 N/A throughout the study. For each trial, nasal pressure was lowered (% of total AH events) from the holding pressure by 1 cm H2O for 4-6 breaths and Mixed apnea 0 ± 0 11.8 ± 6.0 N/A then returned to holding pressure for 1 min before dropping to (% of total AH events) the next level. This sequence was repeated until airflow ceased (absolute Pcrit) or arousal occurred. Obstructive hypopnea 72.3 ± 14.4 50.6 ± 11.6 0.26 (% of total AH events) Data Analysis Central hypopnea 0 ± 0 4.7 ± 4.7 N/A For the CO reserve assessment, central apnea was defined (% of total AH events) 2 as absence of airflow and respiratory effort for ≥ 10 sec. The apnea threshold was determined by averaging the P CO of the BMI, body mass index; AHI, apnea-hypopnea index. ET 2 3 consecutive breaths immediately preceding the apnea.8 The difference between eupneic PETCO2 during stable breathing and The experiment was completed within 2 weeks following the the apneic threshold PETCO2 was calculated as the CO2 reserve. diagnostic study before the subjects received any treatment. All The absolute Pcrit was defined as the level of mask pressure patients reported to the laboratory in the evening, having re- at which inspiratory airflow first ceased. We were able to obtain frained from alcohol and caffeinated beverages during or after this in 18 of 21 subjects. In addition, in all subjects, we obtained their evening meal. Zolpidem 10 mg was given prior to bed to a derived Pcrit as determined from peak inspiratory flow-UAW facilitate sleep and to suppress the arousability from sleep for pressure relationships. Peak inspiratory flow of the 3rd through purpose of measuring Pcrit and apneic threshold. 5th breaths with unambiguous flow limitation during reduction in CPAP was averaged at each level of mask pressure. Pcrit was Experimental Set-Up derived by the zero-flow intercept from the least-square linear Subjects slept with a full face mask, through which they were regression of maximal flow vs. mask pressure as previously de- connected to a breathing circuit that could be directed to either a scribed.9 All data were collected only from flow-limited breaths positive pressure source (ventilator) (1~25 cm H2O) �������������or an adjust- with no associated arousal. able negative pressure source (-1~-10 cm H2O) from wall suction. Unpaired t-test was used for all of comparisons between the A 200 liter capacitance was placed in the inflow port to maintain 2 groups.
Load more

Recommended publications
  • Lesson 1 ELECTROMYOGRAPHY 1 Motor Unit Recruitment
    Physiology Lessons for use with the Biopac Science Lab MP40 Lesson 12 Respiration 1 Apnea PC running Windows® XP or Mac® OS X 10.3-10.4 Lesson Revision 3.15.2006 BIOPAC Systems, Inc. 42 Aero Camino, Goleta, CA 93117 (805) 685-0066, Fax (805) 685-0067 [email protected] www.biopac.com © BIOPAC Systems, Inc. 2006 Page 2 Biopac Science Lab Lesson 12 The Respiratory Cycle I. SCIENTIFIC PRINCIPLES All body cells require oxygen for metabolism and produce carbon dioxide as a metabolic waste product. The respiratory system supplies oxygen to the blood for delivery to cells, and removes carbon dioxide added to the blood by the cells. Cyclically breathing in and out while simultaneously circulating blood between the lungs and other body tissues facilitates the exchange of oxygen and carbon dioxide between the body and the external environment. This process serves cells by maintaining rates of oxygen delivery and carbon dioxide removal adequate to meet the cells’ metabolic needs. The breathing cycle, or respiratory cycle, consists of inspiration during which new air containing oxygen is inhaled, followed by expiration during which old air containing carbon dioxide is exhaled. Average adult people at rest breathe at a frequency of 12 to 15 breaths per minute (BPM), and with each cycle, move an equal volume of air, called tidal volume (TV), into and back out of the lungs. The actual value of tidal volume varies in direct proportion to the depth of inspiration. During normal, quiet, unlabored breathing (eupnea) at rest, adult tidal volume is about 450 ml to 500 ml.
    [Show full text]
  • Design of Respiration Rate Meter Using Flexible Sensor
    JEEMI, Vol. 2, No. 1, January 2020, pp: 13-18 DOI: 10.35882/jeeemi.v2i1.3 ISSN:2656-8632 Design of Respiration Rate Meter Using Flexible Sensor Sarah Aghnia Miyagi#,1, Muhammad Ridha Mak’ruf1, Endang Dian Setyoningsih1, Tarak Das2 1Department of Electromedical Engineering Poltekkes Kemenkes, Surabaya Jl. Pucang Jajar Timur No. 10, Surabaya, 60245, Indonesia 2Department of Biomedical Engineering Netaji Subhash, Engineering College Kolkata, India #[email protected], [email protected], [email protected], [email protected] Abstract— Respiration rate is an important physiological parameter that helps to provide important information about the patient's health status, especially from the human respiratory system. So it is necessary to measure the human respiratory rate by calculating the number of respiratory frequencies within 1 minute. The respiratory rate meter is a tool used to calculate the respiratory rate by counting the number of breaths for 1 minute. The author makes a tool to detect human respiratory rate by using a sensor that detects the ascend and descend of the chest cavity based on a microcontroller so that the operator can measure the breathing rate more practically and accurately. Component tool contains analog signal conditioning circuit and microcontroller circuit accompanied by display in the form of LCD TFT. The results of measurement data on 10 respondents obtained an average error value, namely the position of the right chest cavity 6.6%, middle chest cavity 7.92%, and left chest cavity 6.85%. This value is still below the error tolerance limit of 10%. It can be concluded that to obtain the best measurement results, the sensor is placed in the position of the right chest cavity.
    [Show full text]
  • Chapter 22 *Lecture Powerpoint
    Chapter 22 *Lecture PowerPoint The Respiratory System *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • Breathing represents life! – First breath of a newborn baby – Last gasp of a dying person • All body processes directly or indirectly require ATP – ATP synthesis requires oxygen and produces carbon dioxide – Drives the need to breathe to take in oxygen, and eliminate carbon dioxide 22-2 Anatomy of the Respiratory System • Expected Learning Outcomes – State the functions of the respiratory system – Name and describe the organs of this system – Trace the flow of air from the nose to the pulmonary alveoli – Relate the function of any portion of the respiratory tract to its gross and microscopic anatomy 22-3 Anatomy of the Respiratory System • The respiratory system consists of a system of tubes that delivers air to the lung – Oxygen diffuses into the blood, and carbon dioxide diffuses out • Respiratory and cardiovascular systems work together to deliver oxygen to the tissues and remove carbon dioxide – Considered jointly as cardiopulmonary system – Disorders of lungs directly effect the heart and vice versa • Respiratory system and the urinary system collaborate to regulate the body’s acid–base balance 22-4 Anatomy of the Respiratory System • Respiration has three meanings – Ventilation of the lungs (breathing) – The exchange of gases between the air and blood, and between blood and the tissue fluid – The use of oxygen in cellular metabolism 22-5 Anatomy of the Respiratory System • Functions – Provides O2 and CO2 exchange between blood and air – Serves for speech and other vocalizations – Provides the sense of smell – Affects pH of body fluids by eliminating CO2 22-6 Anatomy of the Respiratory System Cont.
    [Show full text]
  • Introduction to the Respiratory System
    C h a p t e r 15 The Respiratory System PowerPoint® Lecture Slides prepared by Jason LaPres Lone Star College - North Harris Copyright © 2010 Pearson Education, Inc. Copyright © 2010 Pearson Education, Inc. Introduction to the Respiratory System • The Respiratory System – Cells produce energy: • For maintenance, growth, defense, and division • Through mechanisms that use oxygen and produce carbon dioxide Copyright © 2010 Pearson Education, Inc. Introduction to the Respiratory System • Oxygen – Is obtained from the air by diffusion across delicate exchange surfaces of the lungs – Is carried to cells by the cardiovascular system, which also returns carbon dioxide to the lungs Copyright © 2010 Pearson Education, Inc. 15-1 The respiratory system, composed of conducting and respiratory portions, has several basic functions Copyright © 2010 Pearson Education, Inc. Functions of the Respiratory System • Provides extensive gas exchange surface area between air and circulating blood • Moves air to and from exchange surfaces of lungs • Protects respiratory surfaces from outside environment • Produces sounds • Participates in olfactory sense Copyright © 2010 Pearson Education, Inc. Components of the Respiratory System • The Respiratory Tract – Consists of a conducting portion • From nasal cavity to terminal bronchioles – Consists of a respiratory portion • The respiratory bronchioles and alveoli The Respiratory Tract Copyright © 2010 Pearson Education, Inc. Components of the Respiratory System • Alveoli – Are air-filled pockets within the lungs:
    [Show full text]
  • Respiratory System.Pdf
    Respiratory System Respiratory System - Overview: Assists in the detection Protects system of odorants Respiratory (debris / pathogens / dessication) System 5 3 4 Produces sound (vocalization) Provides surface area for gas exchange (between air / blood) 1 2 For the body to survive, there must be a constant supply of Moves air to / from gas O2 and a constant exchange surface disposal of CO 2 Marieb & Hoehn (Human Anatomy and Physiology, 8th ed.) – Table 19.1 Respiratory System Respiratory System Functional Anatomy: Functional Anatomy: Trachea Epiglottis Naming of pathways: • > 1 mm diameter = bronchus Upper Respiratory • Conduction of air • < 1 mm diameter = bronchiole System • Gas exchange Primary • < 0.5 mm diameter = terminal bronchiole Bronchus • Filters / warms / humidifies Lower Respiratory Bronchi System incoming air bifurcation (23 orders) 1) External nares 5) Larynx 2) Nasal cavity • Provide open airway Green = Conducting zone • Resonance chamber • channel air / food Purple = Respiratory zone 3) Uvula • voice production (link) 4) Pharynx 6) Trachea 7) Bronchial tree • Nasopharynx Bronchiole 8) Alveoli • Oropharynx Terminal Bronchiole Respiratory Bronchiole • Laryngopharynx Alveolus Martini et. al. (Fundamentals of Anatomy and Physiology, 7th ed.) – Figure 23.1 Martini et. al. (Fundamentals of Anatomy and Physiology, 7th ed.) – Figure 23.9 Respiratory System Respiratory System Functional Anatomy: Functional Anatomy: Respiratory Mucosa / Submucosa: How are inhaled debris / pathogens cleared from respiratory tract? Near Near trachea alveoli Nasal Cavity: Epithelium: Particles > 10 µm Pseudostratified Simple columnar cuboidal Conducting Zone: Particles 5 – 10 µm Cilia No cilia Respiratory Zone: Mucus Escalator Particles 1 – 5 µm Mucosa: Lamina Propria (areolar tissue layer): Mucous membrane (epithelium / areolar tissue) smooth smooth muscle muscle Mucous No glands mucous glands Cartilage: Rings Plates / none Macrophages Martini et.
    [Show full text]
  • Medical Term for Breathing Out
    Medical Term For Breathing Out EgbertPsychographic substantivize Vlad disproves,noisily or demagnetizing his hoggeries disgustany foot-lambert. sned fatuously. Rochester Fonz kiddingremains just-in-time. shrubbier after In these effects on and out isolated from the term for medical sciences centre in infants may also helps improve symptoms The medical center in for a how it up along with either have over weeks or poisons that exercise and cause and results in. When Breathing Goes Awry Scientific American. To ray out these conditions, Dr. Find a comfortable, quiet location and rally in a alert or reclined position. Diagnosis of breathing problems is based on a careful medical history, physical examination, and possibly the diffuse of tests. But it out for medical term used in through your medications provide relief by how do what works for? Chest expansion on inspiration should gave the same environment similar with each breath. Patients usually means that provide a review of the time limit activity that can you can cause symptoms that looks like? This term for? Find out of some examples are trademarks of a term for lowering or ascending respiratory homeostasis, one hand to your exposure to better agreement on. In three pillows under your bed and people maintain all the blood vessels to lungs and in your windpipe, you reduce pain? Certain information only good. Belly breathing can net you stiff your diaphragm properly. This test is cable more accurate measurement of your baseline lung function. This bullshit may help us understand, prevent, and treat lung problems common in preterm babies. With the COVID-19 pandemic you now consider evidence outside trips are already it.
    [Show full text]
  • User's Manual
    1 2 . 20 LC IngMar Medical, L IngMar © , Part No. 80 20 200 3 Manual Rev. Breather, QuickLung User’ s USA Toll Free: 1 (800) 583-9910 | International:+1 (412) 441-8228 | [email protected] 21 . 20 LC IngMar Medical, L IngMar © 3 Document History Revision History Date Authors Rev. 1 6/20/2017 Stefan Frembgen/Michael Bails Rev. 2 9/24/2018 Samantha Schadwinkel Manual Rev. Breather, QuickLung s Rev. 3 2/24/2021 Michael Bails ’ User 2 LEGAL INFORMATION Product Warranty Educational tools and test instruments manufactured or distributed by IngMar Medical come with a limited warranty, covering materials and workmanship, for a period of one year from the date of shipment, except for products with stated warranties other than one year. Software, fuses and batteries are excluded from this warranty. System components such as computers are supplied with the factory warranty of the original manufacturer. IngMar Medical reserves the right to perform warranty service(s) at its factory, at an authorized repair center, or at the customer's installation. IngMar Medical's obligations under this warranty are limited to repairs, or at IngMar Medical's option, replacement of any defective parts of the purchased equipment, without charge, if said defects occur during normal service. Claims for damages during shipment must be filed promptly with the transportation company. All correspondence concerning the equipment must specify both the model name and number, and the serial number as it appears on the equipment. Improper use, mishandling, tampering with, or operation of the equipment without following specific operating instructions will void this warranty and release IngMar Medical from any further warranty obligations.
    [Show full text]
  • Measuring Respiration Rate Based on Android
    IJEEMI, Vol. 1, No. 1, Agustus 2019, pp: 39-44 DOI: 10.35882/ijeeemi.v1i1.7 ISSN:2656-8624 Measuring Respiration Rate Based on Android I Kadek Eman Giyana Mahardika, Torib Hamzah, Triana Rahmawati, Liliek Soetjiatie Department of Electromedical Engineering Poltekkes Kemenkes Surabaya Surabaya, Indonesia [email protected], [email protected], [email protected] Abstract- Respiratory rate measurement tool is a technique used to determine the number of respiratory activities a person every minute. In the classification of the number of breathing per minute which can be divided into three groups, namely the so-called eupnea/normal, above average breathing called tachypnea, while below the average so-called bradypnea. This method is highly dependent on the concentration of the mind and senses actor sensitivity measurement and observation. Therefore, human nature is easy to forget, tired and bored, so now developed a method of measurement or observation of respiratory rate electronically. In this study, respiratory rate measurement making use flex sensor by placing the sensor in the patient's stomach and will detect the curvature of the patient's stomach. Results from the patient's respiratory displayed on the LCD Character and android using HC-05 Bluetooth as the media sender. The results of the measurement data of the 10 respondents indicated the average - average error of 3.2%. After testing and data collection can be concluded that the appliance is eligible to use because it is still within the tolerance range of 10%. Keywords ± Respiratory rate, Flex Sensor, HC-05 Bluetooth, Android I. INTRODUCTION remainder should be discarded because they are toxic to the The respiratory rate measurement tool is a technique used to body.
    [Show full text]
  • RF Sensing Based Breathing Patterns Detection Leveraging USRP Devices
    sensors Article RF Sensing Based Breathing Patterns Detection Leveraging USRP Devices Mubashir Rehman 1,2 , Raza Ali Shah 1, Muhammad Bilal Khan 2,3, Najah Abed AbuAli 4,*, Syed Aziz Shah 5, Xiaodong Yang 3, Akram Alomainy 6, Muhmmad Ali Imran 7,8 and Qammer H. Abbasi 7 1 Department of Electrical Engineering, HITEC University, Taxila 47080, Pakistan; [email protected] (M.R.); [email protected] (R.A.S.) 2 Department of Electrical and Computer Engineering, Attock Campus, COMSATS University Islamabad, Attock 43600, Pakistan; [email protected] 3 School of Electronic Engineering, Xidian University, Xi’an 710071, China; [email protected] 4 College of Information Technology, United Arab Emirates University (UAEU), Al-Ain, United Arab Emirates 5 Research Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK; [email protected] 6 School of Electronic Engineering and Computer Science, Queen Mary University of London, London WC1E 7HU, UK; [email protected] 7 School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; [email protected] (M.A.I.); [email protected] (Q.H.A.) 8 Artificial Intelligence Research Centre (AIRC), Ajman University, Ajman, United Arab Emirates * Correspondence: [email protected] Abstract: Non-contact detection of the breathing patterns in a remote and unobtrusive manner has significant value to healthcare applications and disease diagnosis, such as in COVID-19 infection prediction. During the epidemic prevention and control period of COVID-19, non-contact approaches Citation: Rehman, M.; Shah, R.A.; have great significance because they minimize the physical burden on the patient and have the least Khan, M.B.; AbuAli, N.A.; Shah, S.A.; requirement of active cooperation of the infected individual.
    [Show full text]
  • Respiration Rate (R.R): Is the Act of Breathing; Normal Respiration Is Slightly Observable, Quiet, Effortless, Regular, and Automatic
    University of Kerbala / College of Nursing Fundamentals of Nursing Department Fundamentals of Nursing I Respiration rate (R.R): Is the act of breathing; normal respiration is slightly observable, quiet, effortless, regular, and automatic. Respiration is defined by physiological functioning as: External respiration: the exchange of oxygen and carbon dioxide between the alveoli of the lungs and the pulmonary blood system. Internal respiration: the interchange of oxygen and carbon dioxide between the circulating blood and cells throughout the body. Inspiration (inhalation): the intake of air into the lungs. Expiration (exhalation): refer to breathing out or the movement of gases from the lungs to the atmosphere. Ventilation: refers to the movement of air in and out of the lungs. Respiratory rhythm: the regularity of the expiration and inspiration it can be described as regular or irregular. Respiration normally spaced. Eupnea: breathing that’s normal in rate and depth. Tidal volume: the amount of air taken during normal inspiration and expiration in adults about 500 ml of air. Vital capacity: amount of air exhaled from the lungs after a minimal full inspiration. Type of breathing: a. Costal (thoracic) breathing: involves intercostal muscle and other accessory muscle, such as the sternocleidomastoid muscle. It can be observe by the movement of the chest upward and outward. b. Diaphragmatic (abdominal) breathing: involve the contraction and relaxation of the diaphragm. It can be observe by movement of abdomen. Regulation of breathing: Respiration is controlled by: a. Respiratory centers in the medulla oblongata and the pons of the brain. b. Chemoreceptors located centrally in the medulla and peripherally in the carotid and aortic bodies.
    [Show full text]
  • Respiratory System -Training Handout
    Respiratory System -Training Handout Karen L. Lancour National Rules Committee Chairman – Life Science FUNCTIONS: • Provides oxygen to the blood stream and removes carbon dioxide • Enables sound production or vocalization as expired air passes over the vocal chords. • Enables protective and reflexive non-breathing air movements such as coughing and sneezing, to keep the air passages clear • Control of Acid-Base balance and Control of blood pH PROCESSES: a collective term for the following processes: Pulmonary ventilation - movement of air into the lungs (inspiration) and movement of air out of the lungs (expiration) External respiration - movement of oxygen from the lungs to the blood and movement of carbon dioxide from the blood to the lungs Transport of respiratory gases -Transport of oxygen from the lungs to the tissues and transport of carbon dioxide from the tissues to the lungs Internal respiration - Movement of oxygen from blood to the tissue cells and movement of carbon dioxide from tissue cells to blood 1 PRINCIPAL ORGANS OF THE RESPIRATORY SYSTEM Nose Functions Provides an airway for respiration Moistens and warms entering air Filters and cleans inspired air Resonating chamber for speech Detects odors in the airstream Anatomical features Vibrissae (guard hairs) – stiff hairs that filter large particles from the air Nasal cilia – hair-like projections that propel trapped particles towards the throat for digestion by digestive enzymes Capillaries - rich supply of capillaries warm the inspired air Nasal conchae – folds in the mucous
    [Show full text]
  • A System for Monitoring Breathing Activity Using an Ultrasonic Radar Detection with Low Power Consumption
    Journal of Sensor and Actuator Networks Article A System for Monitoring Breathing Activity Using an Ultrasonic Radar Detection with Low Power Consumption Ali Al-Naji 1,2,*, Ali J. Al-Askery 1 , Sadik Kamel Gharghan 1 and Javaan Chahl 2,3 1 Electrical Engineering Technical College, Middle Technical University, Baghdad 1022, Iraq; [email protected] (A.J.A.-A.); [email protected] (S.K.G.) 2 School of Engineering, University of South Australia, Mawson Lakes, SA 5095, Australia; [email protected] 3 Joint and Operations Analysis Division, Defence Science and Technology Group, Melbourne, VIC 3207, Australia * Correspondence: [email protected] Received: 28 April 2019; Accepted: 22 May 2019; Published: 24 May 2019 Abstract: Continuous monitoring of breathing activity plays a major role in detecting and classifying a breathing abnormality. This work aims to facilitate detection of abnormal breathing syndromes, including tachypnea, bradypnea, central apnea, and irregular breathing by tracking of thorax movement resulting from respiratory rhythms based on ultrasonic radar detection. This paper proposes a non-contact, non-invasive, low cost, low power consumption, portable, and precise system for simultaneous monitoring of normal and abnormal breathing activity in real-time using an ultrasonic PING sensor and microcontroller PIC18F452. Moreover, the obtained abnormal breathing syndrome is reported to the concerned physician’s mobile telephone through a global system for mobile communication (GSM) modem to handle the case depending on the patient’s emergency condition. In addition, the power consumption of the proposed monitoring system is reduced via a duty cycle using an energy-efficient sleep/wake scheme.
    [Show full text]