Non-contact thermography-based respiratory rate monitoring in a post-anesthetic care unit
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ORIGINAL RESEARCH
Non-contact thermography-based respiratory rate monitoring in a post-anesthetic care unit Hye‑Mee Kwon1 · Keita Ikeda2 · Sung‑Hoon Kim1 · Robert H. Thiele2 Received: 8 June 2020 / Accepted: 18 September 2020 © Springer Nature B.V. 2020
Abstract In patients at high risk of respiratory complications, pulse oximetry may not adequately detect hypoventilation events. Previous studies have proposed using thermography, which relies on infrared imaging, to measure respiratory rate (RR). These systems lack support from real-world feasibility testing for widespread acceptance. This study enrolled 101 spontaneously ventilating patients in a post-anesthesia recovery unit. Patients were placed in a 45° reclined position while undergoing pulse oximetry and bioimpedance-based RR monitoring. A thermography camera was placed approximately 1 m from the patient and pointed at the patient’s face, recording continuously at 30 frames per second for 2 min. Simultaneously, RR was manually recorded. Offline imaging analysis identified the nares as a region of interest and then quantified nasal temperature changes frame by frame to estimate RR. The manually calculated RR was compared with both bioimpedance and thermographic estimates. The Pearson correlation coefficient between direct measurement and bioimpedance was 0.69 (R2 = 0.48), and that between direct measurement and thermography was 0.95 ( R2 = 0.90). Limits of agreement analysis revealed a bias of 1.3 and limits of agreement of 10.8 (95% confidence interval 9.07 to 12.5) and − 8.13 (− 6.41 to − 9.84) between direct measurements and bioimpedance, and a bias of −0.139 and limits of agreement of 2.65 (2.14 to 3.15) and − 2.92 (− 2.41 to 3.42) between direct measurements and thermography. Thermography allowed tracking of the manually measured RR in the post-anesthesia recovery unit without requiring patient contact. Additional work is required for image acquisition automation and nostril identification. Keywords Thermography · Respiratory rate · Patient monitoring · Bioimpedance
1 Introduction Multiple components of general anesthesia affect respiratory function, including neuromuscular blockade [1], the use of volatile anesthetic agents [2, 3], and opioids [4]. Respiratory compromise is a major cause of morbidity in the post-anesthesia care unit (PACU) [5, 6], and prevention requires early detection of critical respiratory events for prompt treatment; Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10877-020-00595-8) contains supplementary material, which is available to authorized users. * Sung‑Hoon Kim [email protected] 1
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic‑ro 43‑gil, Songpa‑gu, 05505 Seoul, Korea
Department of Anesthesiology and Pain Medicine, University of Virginia Health System, Charlottesville, VA, USA
2
it also requires risk-stratification to guide appropriate dispositions after the patient leaves the PA
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