Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction

Background and Objective: Respiratory mechanics estimation can be used to guide mechanical ventilation (MV) but is severely compromised when asynchronous breathing occurs. In addition, asynchrony during MV is often not monitored and little is known about the impact or magnitude of asynchronous breat...

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Main Authors:	Chiew, Yeong Shiong, Tan, Chee Pin, Chase, Geoffrey, Chiew, Yeong Woei, Desaive, Thomas, Md Ralib, Azrina, Mat Nor, Mohd Basri
Format:	Article
Language:	English English English
Published:	Elsevier 2018
Subjects:	R Medicine (General) TJ Mechanical engineering and machinery
Online Access:	http://irep.iium.edu.my/61981/ http://irep.iium.edu.my/61981/ http://irep.iium.edu.my/61981/ http://irep.iium.edu.my/61981/2/61981_Assessing%20mechanical%20ventilation%20asynchrony%20through%20iterative%20airway%20pressure%20reconstruction_SCOPUS.pdf http://irep.iium.edu.my/61981/3/61981_Assessing%20mechanical%20ventilation%20asynchrony%20through%20iterative%20airway%20pressure%20reconstruction_WoS.pdf http://irep.iium.edu.my/61981/19/61981_Assessing%20mechanical%20ventilation%20asynchrony.pdf

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spelling	iium-619812018-06-21T00:54:52Z http://irep.iium.edu.my/61981/ Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction Chiew, Yeong Shiong Tan, Chee Pin Chase, Geoffrey Chiew, Yeong Woei Desaive, Thomas Md Ralib, Azrina Mat Nor, Mohd Basri R Medicine (General) TJ Mechanical engineering and machinery Background and Objective: Respiratory mechanics estimation can be used to guide mechanical ventilation (MV) but is severely compromised when asynchronous breathing occurs. In addition, asynchrony during MV is often not monitored and little is known about the impact or magnitude of asynchronous breathing towards recovery. Thus, it is important to monitor and quantify asynchronous breathing over every breath in an automated fashion, enabling the ability to overcome the limitations of model-based respiratory mechanics estimation during asynchronous breathing ventilation. Methods: An iterative airway pressure reconstruction (IPR) method is used to reconstruct asynchronous airway pressure waveforms to better match passive breathing airway waveforms using a single compartment model. The reconstructed pressure enables estimation of respiratory mechanics of airway pressure waveform essentially free from asynchrony. Reconstruction enables real-time breath-to-breath monitoring and quantification of the magnitude of the asynchrony (MAsyn). Results and Discussion: Over 100,000 breathing cycles from MV patients with known asynchronous breathing were analyzed. The IPR was able to reconstruct different types of asynchronous breathing. The resulting respiratory mechanics estimated using pressure reconstruction were more consistent with smaller interquartile range (IQR) compared to respiratory mechanics estimated using asynchronous pressure. Comparing reconstructed pressure with asynchronous pressure waveforms quantifies the magnitude of asynchronous breathing, which has a median value MAsyn for the entire dataset of 3.8%. Conclusion: The iterative pressure reconstruction method is capable of identifying asynchronous breaths and improving respiratory mechanics estimation consistency compared to conventional model-based methods. It provides an opportunity to automate real-time quantification of asynchronous breathing frequency and magnitude that was previously limited to invasively method only. Elsevier 2018-04 Article PeerReviewed application/pdf en http://irep.iium.edu.my/61981/2/61981_Assessing%20mechanical%20ventilation%20asynchrony%20through%20iterative%20airway%20pressure%20reconstruction_SCOPUS.pdf application/pdf en http://irep.iium.edu.my/61981/3/61981_Assessing%20mechanical%20ventilation%20asynchrony%20through%20iterative%20airway%20pressure%20reconstruction_WoS.pdf application/pdf en http://irep.iium.edu.my/61981/19/61981_Assessing%20mechanical%20ventilation%20asynchrony.pdf Chiew, Yeong Shiong and Tan, Chee Pin and Chase, Geoffrey and Chiew, Yeong Woei and Desaive, Thomas and Md Ralib, Azrina and Mat Nor, Mohd Basri (2018) Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction. Computer Methods and Programs in Biomedicine, 157. pp. 217-224. ISSN 0169-2607 https://www.sciencedirect.com/science/article/pii/S0169260717309938 10.1016/j.cmpb.2018.02.007
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English English
topic	R Medicine (General) TJ Mechanical engineering and machinery
spellingShingle	R Medicine (General) TJ Mechanical engineering and machinery Chiew, Yeong Shiong Tan, Chee Pin Chase, Geoffrey Chiew, Yeong Woei Desaive, Thomas Md Ralib, Azrina Mat Nor, Mohd Basri Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction
description	Background and Objective: Respiratory mechanics estimation can be used to guide mechanical ventilation (MV) but is severely compromised when asynchronous breathing occurs. In addition, asynchrony during MV is often not monitored and little is known about the impact or magnitude of asynchronous breathing towards recovery. Thus, it is important to monitor and quantify asynchronous breathing over every breath in an automated fashion, enabling the ability to overcome the limitations of model-based respiratory mechanics estimation during asynchronous breathing ventilation. Methods: An iterative airway pressure reconstruction (IPR) method is used to reconstruct asynchronous airway pressure waveforms to better match passive breathing airway waveforms using a single compartment model. The reconstructed pressure enables estimation of respiratory mechanics of airway pressure waveform essentially free from asynchrony. Reconstruction enables real-time breath-to-breath monitoring and quantification of the magnitude of the asynchrony (MAsyn). Results and Discussion: Over 100,000 breathing cycles from MV patients with known asynchronous breathing were analyzed. The IPR was able to reconstruct different types of asynchronous breathing. The resulting respiratory mechanics estimated using pressure reconstruction were more consistent with smaller interquartile range (IQR) compared to respiratory mechanics estimated using asynchronous pressure. Comparing reconstructed pressure with asynchronous pressure waveforms quantifies the magnitude of asynchronous breathing, which has a median value MAsyn for the entire dataset of 3.8%. Conclusion: The iterative pressure reconstruction method is capable of identifying asynchronous breaths and improving respiratory mechanics estimation consistency compared to conventional model-based methods. It provides an opportunity to automate real-time quantification of asynchronous breathing frequency and magnitude that was previously limited to invasively method only.
format	Article
author	Chiew, Yeong Shiong Tan, Chee Pin Chase, Geoffrey Chiew, Yeong Woei Desaive, Thomas Md Ralib, Azrina Mat Nor, Mohd Basri
author_facet	Chiew, Yeong Shiong Tan, Chee Pin Chase, Geoffrey Chiew, Yeong Woei Desaive, Thomas Md Ralib, Azrina Mat Nor, Mohd Basri
author_sort	Chiew, Yeong Shiong
title	Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction
title_short	Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction
title_full	Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction
title_fullStr	Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction
title_full_unstemmed	Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction
title_sort	assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction
publisher	Elsevier
publishDate	2018
url	http://irep.iium.edu.my/61981/ http://irep.iium.edu.my/61981/ http://irep.iium.edu.my/61981/ http://irep.iium.edu.my/61981/2/61981_Assessing%20mechanical%20ventilation%20asynchrony%20through%20iterative%20airway%20pressure%20reconstruction_SCOPUS.pdf http://irep.iium.edu.my/61981/3/61981_Assessing%20mechanical%20ventilation%20asynchrony%20through%20iterative%20airway%20pressure%20reconstruction_WoS.pdf http://irep.iium.edu.my/61981/19/61981_Assessing%20mechanical%20ventilation%20asynchrony.pdf
first_indexed	2023-09-18T21:27:56Z
last_indexed	2023-09-18T21:27:56Z
_version_	1777412316965371904

Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction

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