Progress and Application of Bioelectrical Impedance Measurement Methods / 中国医疗器械杂志

The bioelectrical impedance measurement is a detection technique that uses the electrical characteristics and changes in human tissues and organs to detect biomedical information related to human physiological and pathological conditions. This article makes a comprehensive introduction from the aspects of impedance cardiography, electrical impedance respiratory monitoring, electrical impedance tomography, electrical impedance gastric dynamics detection technique, contact impedance and so on, as well as comprehensively introduces the progress and application status of bioelectrical impedance measurement methods.

Monitorización cardio respiratoria domiciliaria en lactantes / Home respiratory cardio monitoring in infants

Home cardio-respiratory monitoring began over 40 years ago with the aim of preventing sudden infant death. Although it has been shown that monitoring does not meet this objective, its prescription has been maintained in various clinical situations and with very different criteria. Consensus on the subject has not been able to define precisely the type of monitoring or the time required for different diseases. Among the diseases that still consider the indication of cardio-respiratory monitoring at home are: persistent apnea of prematurity, high-risk BRUE (Brief Resolved Unexplained Events), neurological or metabolic diseases with compromise of the respiratory center, convulsive cough, pathologic gastroesophageal reflux and technology-dependent patients (high flow nasal cannula (CNAF), noninvasive ventilation (NIV), invasive mechanical ventilation (IMV) to tracheostomy, and others). A review is presented on the development of cardio-respiratory monitoring at home, highlighting the true usefulness of this technology with a general proposal, which must be evaluated on a case-by-case basis and always taking into account the conditions that must be met to perform adequate monitoring and useful.

La monitorización cardio-respiratoria en domicilio se inició hace más de 40 años con el objetivo de prevenir la muerte súbita del lactante. Aun cuando se ha demostrado que la monitorización no cumple este objetivo, se ha mantenido su prescripción en diversas situaciones clínicas y con criterios muy diversos. Consensos acerca del tema no han llegado a definir con precisión el tipo de monitorización ni el tiempo requerido para distintas enfermedades. Dentro de las enfermedades que todavía consideran la indicación de monitorización cardio-respiratoria en domicilio se encuentran: apnea persistente del prematuro, BRUE (episodio breve resuelto inexplicado) de alto riesgo, enfermedades neurológicas o metabólicas con compromiso del centro respiratorio, tos convulsiva, reflujo gastroesofágico patológico y pacientes dependientes de tecnología (cánula nasal de alto flujo (CNAF), ventilación no invasiva (VNI), ventilación mecánica invasiva (VMI) a traqueostomía, y otros). Se presenta una revisión sobre el desarrollo de la monitorización cardio-respiratoria en domicilio, resaltando la verdadera utilidad que tendría esta tecnología con una propuesta general, que debe evaluarse caso a caso y siempre teniendo en cuenta las condiciones que deben cumplirse para realizar una monitorización adecuada y útil.

Monitorización respiratoria del paciente pediátrico en la Unidad de Cuidados Intensivos / Respiratory monitoring of pediatric patients in the Intensive Care Unit

Resumen: La monitorización respiratoria representa un importante rol en el cuidado del niño con falla respiratoria aguda. Por tanto, su apropiado uso y correcta interpretación (reconociendo qué señales y variables deben ser priorizadas) deberían ayudar a un mejor entendimiento de la fisiopatología de la enfermedad y de los efectos de las intervenciones terapéuticas. Asimismo, la monitorización del paciente ventilado permite, entre otras determinaciones, evaluar diversos parámetros de la mecánica respiratoria, conocer el estado de los diferentes componentes del sistema respiratorio y guiar los ajustes de la terapia ventilatoria. En esta actualización se describe la utilidad de diversas técnicas de monitorización respiratoria (incluyendo métodos convencionales y otros más recientes), se definen conceptos básicos de mecánica ventilatoria, su interpretación y cómo el adecuado análisis de la información puede ocasionar un impacto en el manejo clínico del paciente.

Abstract: Respiratory monitoring plays an important role in the care of children with acute respiratory failure. Therefore, its proper use and correct interpretation (recognizing which signals and variables should be prioritized) should help to a better understanding of the pathophysiology of the disease and the effects of therapeutic interventions. In addition, ventilated patient monitoring, among other determinations, allows to evaluate various parameters of respiratory mechanics, know the status of the different components of the respiratory system and guide the adjustments of ventilatory therapy. In this update, the usefulness of several techniques of respiratory monitoring including conventional respiratory monitoring and more recent methods are described. Moreover, basic concepts of mechanical ventilation, their interpretation and how the appropriate analysis of the information obtained can cause an impact on the clinical management of the patient are defined.

Research on sleep respiratory monitoring / 国际生物医学工程杂志

The sleeping respiratory monitoring technique is very important to the prophylaxis, detection, and treatment of the sleep apnea syndrome. This article briefly introduces the classification of the monitoring devices and their application trend, analyzes the features of sleep respiratory monitoring techniques, and summarizes the development statue and the research trend.

Monitoreo respiratorio y su rol en Terapia intensiva / Respiratory monitoring and its role in intensive therapy

El monitoreo respiratorio (MR) complementa al juicio clínico y puede estar asociado a la asistencia respiratoria mecánica (ARM) o no. Se reconocen tres períodos asociados al desarrollo del MR: entre 1964 y 1974 el MR lo constituía la medición de pH y gases en sangre arterial, y la medición de volumen minuto respiratorio era excepcional. Entre 1975 y 1985 seintrodujeron componentes electrónicos en los respiradores y se disponía de respiradores volumétricos con espirómetro incorporado, permitiendo desarrollar técnicas de mediciónde compliance y otros valores derivados. También se desarrolló la oxicapnometría, que se transformó en un auxiliar para el control de la respiración. El último período comenzó en 1985 y se caracteriza por la aparición de respiradores microprocesados, que suministrandiferentes modos ventilatorios y de monitores simples y fáciles de operar, capaces de determinar variables mecánicas antes reservadas a laboratorios de fisiopatología. Estosrespiradores de alta tecnología contienen monitores que informan en tiempo real sobre diversas variables durante la ARM, pero que al retirar el respirador dejan de informar. Sedebería aprovechar la disponibilidad de monitores aislados para continuar con el monitoreo, aún después del retiro del respirador, lo cual ha demostrado ser beneficioso.

Respiratory monitoring (RM) complements the clinical judgement and may be associated or not with mechanical ventilation (MV). Three periods in relation to the development of RM could be recognized: from 1964 to 1974 RM was done by pH and blood gases measurements, the measurement of minute ventilation was not routinely performed. Between 1975 and 1985 electronic components were introduced in the ventilators and volumetric ventilators with incorporated spirometer became available permitting the measuring of compliance and other derived measurements. After becoming available, oxicapnometry was considereda useful tool for monitoring respiration. The last period began in 1985 and was characterized by the arising of microprocessed ventilators able to provide different ventilatory modalities,equipped with simple and easy to operate monitors that could calculate mechanical variables that in the past were limited to respiratory physiology laboratories. These high tech ventilators are equipped with monitors informing at real time about physiological variables,however, after the weaning this information stops to be available. The availability of those stand alone monitors should be taken into account to continue the monitoring, even after the weaning; as this has been demonstrated to be beneficial.

Evaluation of ambulatory oxygen uptake monitor / 体力科学

A portable device for long-term monitoring of oxygen uptake without discomfort has been developed based on a flow-through principle. The oxygen content of the exhaust gas was kept constant by a servo-controlled blower, so that the flow rate was essentially proportional to the oxygen uptake. This system was evaluated by both a bench test and in exercising human subjects. The limiting current-type oxygen sensor used this portable device produced results which were in good agreement those obtained using a zirconia oxygen sensor (r= 0.999), and stable values were obtained for at least 15 h. The response time for a stepped oxygen change was 4 s. The air flow rate produced by the blower was proportional to the supplied voltage. The results using a time-of-flight flowmeter were highly correlated with those for a hot-wire anemometer (r=0, 999) . The oxygen uptake of exercising human subjects measured with this portable device showed good agreement with that obtained by a conventional oxygen monitor (r=0.973 for cycle ergometer, r=0, 932 for treadmill) . This portable device was able to measure oxygen uptake in subjects during daily activities, and also while driving a car, without disturbance.