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Comparison of blood pressure measured by oscillometry from the supraorbital artery and invasively from the radial artery.

In previous studies, oscillometric blood pressure measured from the supraorbital artery has been shown to agree quite well with pressure measured from the brachial artery in normal subjects. In this study, surgical patients whose conditions warranted the use of invasive blood pressure monitoring during the surgery were chosen. We compared systolic and diastolic blood pressure measured oscillometrically from the supraorbital artery with intraarterial blood pressures, measured invasively from the radial artery. A pressure bladder was attached to the forehead of each patient. The bladder was connected to a forehead blood pressure monitor. A catheter was inserted in a radial artery, and connected to a pressure monitor. Forehead blood pressure was measured every 5 min. Radial arterial pressure was averaged over the same period during which the forehead measurement was made. Blood pressures measured with the two methods were compared. For the systolic pressure, the difference between the two methods was -9.9 +/- 17.9 mm Hg (mean +/- SD). For diastolic pressure, the difference was -8.0 +/- 10.9 mm Hg. There was a significant difference between the two methods in the patient population chosen in this study.

Adult↗

Spirometry and forced oscillometry assisted optimal frequency band determination for the computerized analysis of tracheal lung sounds in asthma.

We analysed respiration sounds of individual asthmatic patients, in the scope of the development of a method for computerized recognition of the degree of airway obstruction. Respiration sounds were recorded during laboratory sessions of histamine-provoked airway obstruction. We applied an interpolation technique using supervised artificial neural networks to investigate the optimal frequency band required for studying tracheal asthmatic lung sounds. The optimal band was found to be 100-2300 Hz. The forced expiratory volume in 1 s (FEV1) and the respiratory resistance parameter Rrs(4) were used to describe the degree of airway obstruction that is associated with the lung sounds. By comparing the results obtained with the two parameters, we found that for parametrization of the associated degree of airway obstruction respiratory resistance measurements are preferable over forced expiratory volume measurements.

Adult↗

Physiological analysis of extended-spectrum oscillometry.

Using a forced oscillation technique, the resistance and reactance of the respiratory system in a frequency range between 4 and 52 Hz were described in a group of healthy subjects and a group of patients with severe chronic obstructive pulmonary disease (COPD). In normal subjects, resistance values increased at higher frequencies. As compared to the results in normal subjects, resistance values were much higher and decreased with frequency in COPD patients. Reactance values were more negative, resulting in an increase of resonant frequency. Using matrix network topography, these findings were analyzed in a modified Mead's model. Compressibility of alveolar gas was incorporated in the model calculations. Resistance and reactance values slightly decreased by adding gas compliance in the model calculations. Our results support Mead's hypothesis that the shunt compliance is formed by the compliance of intrathoracic airway walls. Input impedance measurement by forced oscillation is therefore an easily implemented, non-invasive method to investigate respiratory mechanics not requiring active cooperation from the subject. Analysis of resistance and reactance over an extended frequency range gives information about the distribution of resistance along the bronchial system and about compliance of the intrathoracic airway walls as expanding structures in parallel with the air spaces.

Airway Resistance↗

Impulse oscillometry: reference values in children 100 to 150 cm in height and 3 to 10 years of age.

OBJECTIVES: To generate reference equations in North American children to be used for assessing respiratory function through the forced oscillation (Rfo) technique, and to determine the changes in oscillatory resistance, reactance, and resonant frequency (Fres) in relation to age, body height, and weight. DESIGN/SETTING: A prospective cross-sectional study performed on healthy children selected according to strict criteria of American Thoracic Society and European Respiratory Society recommendations. MEASUREMENTS: Triplicate measures were obtained of resistance and reactance at 5, 10, 15, 20, 25, and 35 Hz as well as Fres through the impulse oscillometer (MasterScreen IOS; Jaeger/Toennies; Höchberg, Germany). Two hundred twenty-two white children--normally distributed within the 3- to 10-year age range and 100 to 150 cm in height--were recruited in Montreal, Canada. We used regression analysis to generate multiple predictive equations separately per gender and frequency on age, height, and body weight. RESULTS: Stepwise multiple regression in both natural and logarithmic forms for height, weight, age, and gender showed that standing height was the only significant predictor for all variables. Minimal variability was noted in each subject among the triplicate measurements (p = 0.68 to 0.96). Coherence was > 0.9 at all oscillating frequencies except 5 Hz (< 0.72), with tendencies to lower values in young children. CONCLUSIONS: Resistance and Fres decrease by height, but also by age; and reactance increases. As opposed to our past experience with spirometry in compatible age groups, the Rfo technique was well accepted by preschool children.

Body Height↗

[Oscillometry on various stape protheses. Experimental examination of human temporal bone preparations].

In human temporal bone specimens the vibrations of the labyrinthine fluid were measured by a piezoelectric system after application of various techniques of otosclerosis surgery. Compared with the amplitude in the case of a normal stapes, the surgical techniques according to Zangemeister, Shea and Schuknect resulted in considerable transmission losses in the high frequency range, while transmission of low frequencies to the inner ear was almost equivalent to normal transmission via the stapes. For frequencies of more than 3,000 Hertz the damping influence of the fibrous tissue implanted into the oval window was verified. The results of surgery according to Zangemeister, Shea and Schuknechtdid not differ significantly in the low and medium frequency range. Only a Robinson prosthesis implanted like a Teflon piston caused an impairment of transmission, while the method of fitting this prosthesis onto fibrous tissue was equilvalent to the other techniques.

Ear, Middle↗

Noninvasive blood pressure performance: a reproducible method for quantifying motion artifact tolerance in oscillometry.

Motion artifact tends to degrade oscillometric noninvasive blood pressure measurement (NIBP) accuracy and other aspects of performance (measurement time, patient comfort, false-positive readings). Medical personnel generally have not fully appreciated the extent of these degradations, in part because NIBP provides no waveform display to allow visualization of artifact disruption (unlike the electrocardiography (ECG) and pulse oximetry (SpO2) patient channels). More importantly, the magnitude and frequency of NIBP errors has also gone unappreciated because the auditory noise produced by transport vibration prevents accurate quantification of NIBP accuracy by the traditional auscultatory method. To overcome these problems, a commercially available NIBP simulator was modified to permit the superimposition of repeatable motion artifact waveforms from a function generator onto known patient blood pressure profiles available in the NIBP simulator. The superimposed artifact waveforms had been collected under transport conditions. This methodology enabled comparisons between artifact-free NIBP readings, on the one hand, and artifact-contaminated readings on the other. Monitors under test were subjected to multiple combinations of patient and artifact profiles. Measurement errors were expressed as a percent deviation of the artifact-contaminated readings from the expected (artifact-free) readings. Statistical analyses of the data compared the performance of the different monitor types with nonparametric tests of inference (Kruskal-Wallis H test, Mann-Whitney U test, and chi-squared test). These analyses demonstrated statistically significant differences in performance including accuracy, yield (incidence of values within various error categories), retries, measurement time, and false-positive readings under artifact-only conditions. The method further demonstrated that the monitor using ECG synchronization to filter motion artifact achieved statistically and clinically significant improvements in accuracy without compromising clinical expectations for measurement time. This approach provided a reproducible and quantifiable method by which to assess and differentiate the artifact tolerance of different NIBP technologies.

Artifacts↗