2011 OPEN FORUM Abstracts
COMFORT EVALUATION OF NONINVASIVE RESPIRATORY MONITORING INTERFACES.
Jonathan B. Waugh, Chad A. Epps; Clinical and Diagnostic Sciences, University of Alabama at Birmingham, Birmingham, AL
Background: Respiratory rate (RR) is an established vital sign and a parameter for monitoring patient ventilation status. Many patient populations (postoperative, patient controlled analgesia, procedural sedation and analgesia, labile respiratory drive) benefit from electronic monitoring of respiratory frequency. Noninvasive monitoring of RR can be accomplished using several different technologies with programmable alarms. It is known that the comfort of noninvasive monitors influences patient compliance (Ayhan H. J Adv Nurs 2009;65(5):1237-47 and Costello RW. Thorax 1995:50(4):405-406). Our aim was to evaluate the comfort of two respiratory frequency monitoring device interfaces (Masimo(R) Rainbow Acoustic Sensor TM (RAS) and Oridion(R) Smart Capnoline(R) H Plus) by participants using a written rating scale. The purpose of this study is to determine the comfort rating for each device and if there is a difference in the comfort ratings for the two respiratory frequency monitoring devices. Method: The Masimo Rainbow Acoustic Monitoring TM option on the Rad-87 (R) monitor measures RR using an adhesive acoustic sensor on the neck. The Oridion Microstream(R) capnograph measures RR by detecting changes in exhaled carbon dioxide at the nostril (nasal/oral sampling Smart Capnoline H Plus in this case). In this ongoing IRB-approved study, 10 healthy, adult volunteers (ages 20-37 yrs., 30% male) were observed wearing each interface for 20 minutes (10 min with 2 L/min gas flow via nasal cannula, 10 min without). At the conclusion of each 20 minute session participants completed a seven question rating instrument. Participant comfort was measured using a rating scale incorporating the descriptive analogue technique from ergonomics research principles described by D.J. Oborne (Applied Egronomics 1976;7(4):201-204). Variables were analyzed using the Wilcoxon Signed Rank test, with subjects serving as their own control. Both devices are FDA-cleared for market. Results: A summary of the results is given in Table 1. Conclusions: The ability to achieve significant differences with the more conservative threshold of a nonparametric test indicates continued measurement is merited to allow for parametric analysis. Four of the seven questions rating aspects of comfort indicated the Smart Capnoline H Plus may be more comfortable for monitoring RR with spontaneously breathing patients which could have implications for patient compliance.
Sponsored Research - This study was sponsored through our university's Office of Sponsored Projects with the required oversight of the Conflict of Interest Board to ensure research integrity.
Table 1. Summary of Results