Accuracy and consistency of respiratory inductive plethysmography for overnight tidal volume measurement

Abstract

To validate the accuracy and consistency of respiratory inductive plethysmography (RIP) in measuring tidal volume after an overnight sleep, tidal volumes of 18 patients with suspected sleepdisordered breathing and 8 normal volunteers were measured simultaneously with RIP (V_TRIP) and with an ultrasonic airflow meter (V_TUFM) before and after an unstrained overnight sleep on supine and lateral decubitus. The bias of the V_TRIP was expressed as (V_TRIP-V_TUFM)/ V_TUFM 100 %, limits of agreement between V_TRIP and V_TUFM was measured by averaged bias ±2s. Results showed that in normal subjects, the bias of RIP before and after overnight sleep was precise and consistent in both supine (0. 7 % and -1. 6 %) and lateral decubitus (3. 7 % and -0. 56 %). In these patients, the bias of RIP before and after sleep in supine also remained small (1. 9% and 1.7%), but it became larger in lateral decubitus (24. 5 % and 20. 4 %) and 11. 5 % exceeded the limits of agreement observed in the evening. The patients’ body mass indices (BMI) were higher than those of normal subjects (median 34. 2 vs. 27. 8 kg/m²). Pooled data showed that the bias of V_TRIP in the morning on lateral decubitus but not on supine was correlated to BMI (Spearman R = 0. 32, n=52,P=0.02). Thus, we were led to conclude that the accuracy of V_TRIP overnight was precise and consistent in normal subjects, but the deviation of V_TRIP measured on lateral decubitus in patients especially in those with excessive obesity was greater, thus, the method should not be used for quantitative determination.

Keywords

sleep study / respiratory inductive plethysmography (RIP) / tidal volume

References

[1] KaplanV, ZhangJ N, RussiE W, et al.. Detection of inspiratory flow limitation during sleep by computer assisted respiratory inductive plethysmography. Eur Respir J, 2000, 15: 570-570

[2] BlochK E, LiY, SacknerM A, et al.. Breathing pattern during sleep disruptive snoring. Eur Respir J, 1997, 10: 576-576

[3] CohnM A, RaoA S V, BroudyM, et al.. The respiratory inductive plethysmograph: A new non-invasive monitor of respiration. Bull Eur Physiopathol Respir, 1982, 18: 643-643

[4] KonnoK, MeadJ. Measurement of the separate volume changes of rib cage and abdomen during breathing. J Appl Physiol, 1967, 22: 407-407

[5] SacknerM A, WatsonH, BelsitoA S, et al.. Calibration of respiratory inductive plethysmograph during natural breathing. J Appl Physiol, 1989, 66: 410-410

[6] BuessC, PietschP, GuggenbuehlW, et al.. A pulsed diagonal-beam ultrasonic airflow meter. J Appl Physiol, 1986, 61: 1195-1195

[7] Bland J M, Altman D G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, 1986, (8): 307

[8] PaekD, McCoolD F. Breathing pattern during varied activities. J Appl Physiol, 1992, 73: 887-887