The interest in measuring physiological parameters (especially arterial blood gases) has grown progressively in parallel to the development of new technologies. Physiological parameters were first measured invasively and at discrete time points; however, it was clearly desirable to measure them continuously and non-invasively. The development of intensive care units promoted the use of ventilators via oral intubation ventilators via oral intubation and mechanical respiratory variables were progressively studied. Later, the knowledge gained in the hospital was applied to out-of-hospital management. In the present paper we review the invasive and non-invasive techniques for monitoring respiratory variables.
References
[1]
Domingo, Ch.; Ortún, V. Design and analysis of health products and services. An example at a specialized COPD unit. Open Resp. Med. J?2008, 2, 7–15.
[2]
Luján, M.; Moreno, A.; Veigas, C.; Montón, C.; Pomares, S.; Domingo, Ch. Non-invasive home mechanical ventilation: effectiveness and efficiency of an outpatient initiation protocol compared with the standard in-hospital model. Respir. Med?2007, 101, 1177–1182.
[3]
Domingo, Ch.; Sans-Torres, J.; Solà, J.; Espuelas, H.; Marín, A. Effectiveness and efficiency of a specialized unit in the care of patients with chronic obstructive pulmonary disease and respiratory insufficiency. Arch. Bronconeumol?2006, 42, 104–112.
[4]
McIntosh, A.; Thie, J. The development of a new model for community telemedicine services. J. Telemed. Telecare?2001, 7, 69–72.
[5]
Domingo, Ch. Home oxygen therapy for the 21st century. Curr. Resp. Med. Rev?2006, 2, 237–251.
[6]
Clarke, M. A reference architecture for telemonitoring. Stud. Technol?2004, 103, 381–384.
[7]
De Toledo, P.; Jiménez, S.; Del Pozo, F. A telemedicine system to support a new model for care of chronically ill patients. J. Telemed. Telecare?2002, 8, 17–19.
[8]
Koizumi, T.; Yamaguchi, S.; Hanaoka, M.; Fujimoto, K.; Kubo, K.; Nakai, K.; Takizawa, M.; Murase, S.; Kobayashi, T.; Suzuoka, M. Telemedicine support system in home care of patients with chronic respiratory failure: preliminary results. Nihon Kokyuki Gakkai Zasshi?2003, 41, 173–176. (article in Japanese, abstract in English).
[9]
Mair, F.S.; Wilkinson, M.; Bonnar, S.A.; Wootton, R.; Angus, R.M. The role of telecare in the management of chronic obstructive pulmonary disease in the home. J. Telemed. Telecare?1999, 5, 66–67.
[10]
Domingo, Ch.; Roig, J.; Coll, R.; Klamburg, J.; Izquierdo, J.; Ruiz-Manzano, J.; Morera, J.; Domingo, E. Evaluation of the use of three different devices for nocturnal oxygen therapy in COPD patients. Respiration?1996, 63, 230–235.
[11]
Domingo, Ch.; Klamburg, J.; Roig, J.; Coll, R.; Izquierdo, J.; Morera, J.; Serés, L; Domingo, E. Acute and long-term haemodynamic response to home oxygen therapy: nasal prongs versus oxygen saving devices. J. Appl. Res?2004, 4, 149–163.
[12]
Domingo, Ch.; Canturri, E.; Luján, M.; Moreno, A.; Espuelas, H.; Marín, A. Transcutaneous measurement of partial pressure of carbon dioxide and oxygen saturation: validation of the SenTec monitor. Arch. Bronconeumol?2006, 42, 245–250.
[13]
Lujan, M.; Canturri, E.; Moreno, A.; Arranz, M.; Vigil, L.; Domingo, Ch. Capnometry in spontaneously breathing patients: influence of chronic obstructive pulmonary disease and expiration manoeuvres. Med. Sci. Mon?2008, 14, 485–492.
[14]
Baumberger, J.P.; Goodfriend, R.B. Determination of arterial oxygen tension in man by equilibration through intact skin. Fed. Proc?1951, 10, 10.
[15]
Huch, R.; Huch, A.; Lübbers, D. Transcutaneous measurement of blood pO2 (tcpO2). Method and application in perinatal medicine. J. Perinat. Med?1973, 1, 183–190.
[16]
Sauty, A.; Uldry, C.; Debétaz, L.F.; Leuenberger, P.; Fitting, J.W. Differences in PO2 between arterial and arterialized earlobe samples. Eur. Resp. J?1996, 9, 186–189.
[17]
Rüdiger, M.; T?pfer, K.; Hammer, H.; Schmalisch, R.; Wauer, R. A survey of transcutaneous blood gas monitoring among European neonatal intensive care units. B.M.C. Pediatrics?2005, 5, 30–36.
[18]
Dubin, A.; Murias, G.; Estenssoro, E.; Pozo, MO.; Sottile, JP.; Barán, M.; Piacentini, E.; Canales, HS.; Etcheverry, G. End-tidal CO2 pressure determinants during hemorrhagic shock. Intensive Care. Med?2000, 26, 1619–1623.
[19]
Bhavani-Shankar, K.; Kumar, A.Y.; Moseley, H.S.; Ahyee-Hallsworth, R. Terminology and the current limitations of time capnography: a brief review. J. Clin. Monit?1995, 11, 175–182.
[20]
Verschuren, F.; Liistro, G.; Coffeng, R.; Thys, F.; Roeseler, J.; Zech, F.; Reynaert, M. Volumetric capnography as a screening test for pulmonary embolism in the emergency department. Chest?2004, 125, 841–850.
[21]
Hatle, L.; Rokseth, R. The arterial to end-expiratory carbon dioxide tension gradient in acute pulmonary embolism and other cardiopulmonary diseases. Chest?1974, 66, 352–357.
[22]
Barton, C.W.; Bang, E.S. Correlation of end-tidal CO2 measurements to arterial PaCO2 in nonintubated patients. Ann. Emerg. Med?1994, 23, 560–563.
[23]
Takano, Y.; Sakamoto, O.; Kiyofuji, C.; Ito, K. A comparison of the end-tidal CO2 measured by portable capnometer and the arterial PCO2 in spontaneously breathing patients. Resp. Med?2003, 97, 476–481.
[24]
Rohling, R.; Biro, P. Clinical investigation of a new combined pulse oximetry and carbon dioxide tension sensor in adult anesthesia. J. Clin. Monit?1999, 15, 23–27.
[25]
Tschupp, A.; Fanconi, S. A combined ear sensor for pulse oximetry and carbon dioxide tension monitoring: accuracy in critically ill children. Anesth. Analg?2003, 96, 82–84.
[26]
Janssens, JP.; Perrin, E.; Bennani, I.; Muralt, B.; Titelion, Picaud C. Is continuous transcutaneous monitoring of PC02 (TcPC02) over 8 h reliable in adults? Respir. Med?2001, 95, 331–335.
[27]
Kagawa, S.; Otani, N.; Kamide, M.; Gisiger, P.A.; Eberhard, P.; Severinghaus, J.W. Initial transcutaneous PCO2 overshoot with ear probe at 42 degrees C. J. Clin. Monit. Comput?2004, 18, 343–345.
[28]
Domingo, Ch.; Canturri, E.; Moreno, A.; Espuelas, H.; Vigil, L.; Luján, M. Optimal clinical time for reliable measurement of transcutaneous CO2 with ear probe. Sensors?2010. (in press).
[29]
Kallet, R.H.; Alonso, J.A.; Pittet, J.F.; Matthay, M.A. Prognostic value of the pulmonary dead-space fraction during the first 6 days of acute respiratory distress syndrome. Respir. Care?2004, 49, 1008–1014.
Chatburn, R.L.; Primiano, F.P., Jr. Mathematical models of respiratory mechanics. In Fundamentals of respiratory care research; Chatburn, R.L., Craig, K.C., Eds.; Appleton & Lange: Norwalk, CT, USA, 1998; pp. 59–100.
[32]
Bates, J.H.T. Assessment of mechanics. Physiological basis of ventilatory support. Marcel Dekker?1998, 8, 231–259.
[33]
Lucangelo, U.; Bernabé, F.; Blanch, L. Lung mechanics at the bedside: make it simple. Curr. Opin. Crit. Care?2007, 13, 64–72.
[34]
Blanch, L.; Bernabé, F.; Lucangelo, U. Measurement of air trapping, intrinsic positive end-expiratory pressure, and dynamic hyperinflation in mechanically ventilated patients. Respir. Care?2005, 50, 110–123.
[35]
Lucangelo, U.; Bernabé, F.; Blanch, L. Respiratory mechanics derived from signals in the ventilator circuit. Respir. Care?2005, 50, 55–65.
[36]
Bigatello, L.M.; Davignon, K.R.; Stelfox, H.T. Respiratory mechanics and ventilator waveforms in the patient with acute lung injury. Respir. Care?2005, 50, 235–244.
[37]
Dhand, R. Ventilator graphics and respiratory mechanics in the patient with obstructive lung disease. Respir. Care?2005, 50, 246–259.
Terragni, P.P.; Rosboch, G.; Tealdi, A.; Corno, E.; Menaldo, E.; Davini, O.; Gandini, G.; Herrmann, P.; Mascia, L.; Quintel, M.; Slutsky, A.S.; Gattinoni, L.; Ranieri, V.M. Tidal hyperinflation during low tidal volume ventilation in acute respiratory distress syndrome. Am. J. Respir. Crit. Care Med?2007, 175, 160–166.
[40]
Grasso, S.; Stripoli, T.; De Michele, M.; Bruno, F.; Moschetta, M.; Angelelli, G.; Munno, I.; Ruggiero, V.; Anaclerio, R.; Cafarelli, A.; Driessen, B.; Fiore, T. ARDSnet ventilatory protocol and alveolar hyperinflation: role of positive end-expiratory pressure. Am. J. Respir. Crit. Care Med?2007, 176, 761–767.
[41]
Lotti, G.A.; Braschi, A.; Brunner, J.X.; Palo, A.; Olivei, M.C. Non-invasive evaluation of instantaneous total mechanical activity of the respiratory muscles during pressure support ventilation. Chest?1995, 108, 208–215.
[42]
Sassoon, C.S.; Rosario, N.; Fei, R.; Rheeman, C.H.; Gruer, S.E.; Mahutte, C.K. Influence of pressure- and flow-triggered synchronous intermittent mandatory ventilation on inspiratory muscle work. Crit. Care Med?1994, 22, 1933–1941.
Imanaka, H.; Nishimura, M.; Takeuchi, M.; Kimball, W.R.; Yahagi, N.; Kumon, K. Autotriggering caused by cardiogenic oscillation during flow-triggered mechanical ventilation. Crit. Care Med?2000, 28, 402–407.
[45]
Georgopoulos, D.; Prininakis, G.; Kondili, E. Bedside waveforms interpretation as a tool to identify patient-ventilator asynchronies. Intensive Care Med?2006, 32, 34–47.
Vassilakopoulos, T.; Divangahi, M.; Rallis, G.; Kishta, O.; Petrof, B.; Comtois, A.; Hussain, S.N. Differential cytokine gene expression in the diaphragm in response to strenuous resistive breathing. Am. J. Respir. Crit. Care Med?2004, 170, 154–161.
[48]
Thille, A.W.; Rodriguez, P.; Cabello, B.; Lellouche, F.; Brochard, L. Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med?2006, 32, 1515–1522.
[49]
Fanfulla, F.; Taurino, A.E.; Lupo, ND.; Trentin, R.; D'Ambrosio, C.; Nava, S. Effect of sleep on patient/ventilator asynchrony in patients undergoing chronic non-invasive mechanical ventilation. Respir. Med?2007, 101, 1702–1707.
[50]
Chen, C.W.; Lin, W.C.; Hsu, C.H.; Cheng, K.S.; Lo, C.S. Detecting ineffective triggering in the expiratory phase in mechanically ventilated patients based on airway flow and pressure deflection: feasibility of using a computer algorithm. Crit. Care Med?2008, 36, 455–461.
[51]
Mulqueeny, Q.; Ceriana, P.; Carlucci, A.; Fanfulla, F.; Delmastro, M.; Nava, S. Automatic detection of ineffective triggering and double triggering during mechanical ventilation. Intensive Care Med?2007, 33, 2014–2018.
[52]
Thibault, G.E.; Mulley, A.G.; Barnett, G.O.; Goldstein, R.L.; Reder, V.A.; Sherman, E.L.; Skinner, E.R. Medical intensive care: indications, interventions, and outcomes. N. Engl. J. Med?1980, 302, 938–942.
[53]
Roca, J.; Perez, J.; Colmenero, M.; Mu?oz, H.; Alarcon, L.; Vazquez, G. Professional competence for the care of critical patients: beyond specialities. (in Spanish). Med. Intensiva?2007, 31, 473–484.
Romero, P.V.; Lucangelo, U.; Lopez Aguilar, J.; Fernandez, R.; Blanch, L. Physiologically based indices of volumetric capnography in patients receiving mechanical ventilation. Eur. Respir. J?1997, 10, 1309–1315.
[56]
Lucangelo, U.; Blanch, L. Dead space. Intensive Care Med?2004, 30, 576–579.
[57]
Lucangelo, U.; Bernabé, F.; Vatua, S.; Degrassi, G.; Villagrá, A.; Fernández, R.; Romero, P.V.; Saura, P.; Borelli, M.; Blanch, L. Prognostic value of different dead space indices in mechanically ventilated patients with acute lung injury and ARDS. Chest?2008, 133, 62–71.
[58]
Balogh, D.; Kittinger, E.; Benzer, A.; Hackl, J.M. Noise in the ICU. Intensive Care Med?1993, 19, 343–346.
[59]
Aaron, J.N.; Carlisle, C.C.; Carskadon, M.A.; Meyer, T.J.; Hill, N.S.; Millman, R.P. Environmental noise as a cause of sleep disruption in an intermediate respiratory care unit. Sleep?1996, 19, 707–710.
[60]
Murias, G.; Sales, B.; Garcia-Esquirol, O.; Blanch, L. Telemedicine in critical care. Open Respir. Med. J?2009, 3, 10–16.
[61]
De Toledo, P.; Jiménez, S.; Del Pozo, F. A telemedicine system to support a new model for care of chronically ill patients. J. Telemed. Telecare?2002, 8, 17–19.
[62]
FinnTelemedicum and STAKES. eHealth of Finland. Valopayno Oy: Helsinski, Finland, 2007.
[63]
Santy, P.; Marquis-Moulinier, D. Shock Tramatique dans les blessures de Guerre, Analysis d'observations. Bull. Med. Soc. Chir?1918, 44, 205.
[64]
Lerner, E.B.; Moscati, R.M. The golden hour: scientific fact or medical “urban legend”? Acad. Emerg. Med?2001, 8, 758–760.
[65]
Gomez, D.; Berube, M.; Xiong, W.; Ahmed, N.; Haas, B.; Schuurman, N.; Nathens, A.B. Identifying Targets for Potential Interventions to Reduce Rural Trauma Deaths: A Population-Based Analysis. J. Trauma?2009, 66, 1218–1224.
[66]
Owens, P.E.A. Hospital Admissions That Began in the Emergency Department. 2003. Available online: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb1.pdf (accessed on March 20, 2010).
[67]
Wootton, R.; Loane, M.; Mair, F.; Moutray, M.; Harrisson, S.; Sivananthan, S.; Allen, A.; Doolittle, G.; Mclernan, A. The potential for telemedicine in home nursing. J. Telemed. Telecare?1998, 4, 214–218.
[68]
Doolittle, G.C.; Yaezel, A.; Otto, F.; Clemens, C. Hospice care using home-based telemedicine systems. J. Telemed. Telecare?1998, 4, 58–59.
[69]
Riuggero, C.; Sacile, R.; Giacomini, M. Home telecare. J. Telemed. Telecare?1999, 5, 11–17.
[70]
Bratton, R.L. Patient and physician satisfaction with telemedicine for monitoring vital signs. J. Telemed. Telecare?2001, 7, 72–73.
[71]
McIntosh, A.; Thie, J. The development of a new model for community telemedicine services. J. Telemed. Telecare?2001, 7, 69–72.
[72]
Maiolo, C.; Mohamed, E.I.; Fiorani, C.M.; De Lorenzo, A. Home telemonitoring for patients with severe respiratory illness: the Italian experience. J. Telemed. Telecare?2003, 9, 67–71.
[73]
Vitacca, M.; Assoni, G.; Pizzocaro, P.; Guerra, A.; Marchina, L.; Scalvini, S.; Glisenti, F.; Spanevello, A.; Bianchi, L.; Barbano, L.; Giordano, A.; Balbi, B. A pilot study of nurse-led, home monitoring for patients with chronic respiratory failure and with mechanical ventilation assistance. J. Telemed. Telecare?2006, 12, 337–342.
[74]
Dellaca, R.; Gobbi, A.; Govoni, L.; Navajas, D.; Pedotti, A.; Farre, R. A novel simple internet-based system for real time monitoring and optimizing home mechanical ventilation. Proceedings of International Conference on Health, Telemedicine and Social Medicine; 2009; pp. 209–215.
[75]
Corral, J.; González, M.; Pereira, R; Riesco, J.A.; Disdier, C.; Masa, F. Aplicación de la telemedicina para una teleconsulta entre neumología y atención primaria. Informática y Salud?2005, 53, 7–12.
[76]
Corral, J; Masa, J.F; Disdier, C.; Riesco, J.A; Gómez-Espárrago, A; Barquilla, A.; Jiménez, J.J. Respiratory teleconsultation: Telespirometry, teleradiology and telemedical history between primary care clinics and pulmonary unit. Eur Respir. J?2004, 24, 280.