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Respiratory Monitoring by Pulse Oximetry Plethysmogram Analysis in Preterm Infants

Presented at the Neonatal Society 2015 Spring Meeting.

Seddon P1, Sobowiec-Kouman S1, Castronovo G1, Rabe H2, Wertheim D3

1 Respiratory Unit, Royal Alexandra Children’s Hospital, Brighton, UK
2 Trevor Mann Baby Unit, Royal Sussex County Hospital, Brighton, UK
3 Faculty of Science, Engineering and Computing, Kingston University, UK

Background: We have previously shown that respiratory data can be derived from pulse oximetry plethysmogram (pleth) recordings in newborn term babies and older infants (Wertheim et al., 2009, Wertheim et al., 2014). The aim of this study was to examine if respiratory rate can be derived from pleth traces in preterm infants.

Methods: Pulse oximeter pleth, saturation (SpO2) and thoracic/abdominal respiratory inductance plethysmography (RIP) bands were recorded for five minutes from 15 spontaneously breathing infants using a SOMNOscreen Plus system (Somnomedics GmbH, Germany). The pleth data were low pass filtered (LPF) to derive respiratory data using software that we developed using MATLAB (The MathWorks, Inc., USA). Further software was developed in order to display the LPF pleth data together with the thoracic and abdominal band traces as well as SpO2 and pulse rate. Funding was from the NIHR, RfPB scheme; approval was from NRES West Midlands Committee.

Results: Median (range) gestation at birth was 33 (25-36) weeks and median (range) post-conceptional age at time of recording was 35 (32-37) weeks. Periods of the recordings were analysed, excluding segments with clear artefact and/or low amplitude. Visual assessment of the recordings showed good agreement between the LPF pleth and RIP band data in traces. The median pulse rate in the analysed sections was 145/minute. Respiratory rate calculated from the LPF pleth data (median 57, range 32 to 66 breaths/minute) was compared with that computed from the bands (median 62, range 32 to 72 breaths/minute); the median difference (LPF – band) was -4 and the maximum difference was -9 breaths/minute.

Conclusion: Our results indicated good agreement between respiratory rate from LPF pleth traces and RIP bands. This study suggests that respiratory rate can be derived from good quality pleth recordings in spontaneously breathing preterm infants in the first few weeks after birth.

Corresponding author: seddop@gmail.com

1. Wertheim D, Olden C, Savage E and Seddon P. Arch Dis Child Fetal Neonatal Ed., 2009; 94: F301-3
Wertheim D, Parsley C, Burgess S, Dakin C and Seddon P. Acta Paediatr., 2014; 103: e222-4

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