Understanding the mechanics of the respiratory system is crucial for optimizing ventilator settings and ensuring patient safety. While simple models of the respiratory system typically consider only flow resistance and lung compliance, lung tissue resistance is usually neglected. This study investigated the effect of lung tissue viscoelasticity on delivered mechanical power in a physical model of the respiratory system and the possibility of distinguishing tissue resistance from airway resistance using proximal pressure measured at the airway opening. Three different configurations of a passive physical model of the respiratory system representing different mechanical properties (Tissue resistance model, Airway resistance model, and No-resistance model) were tested. The same volume-controlled ventilation and parameters were set for each configuration, with only the inspiratory flow rates being adjusted. Pressure and flow were measured with a Datex-Ohmeda S/5 vital signs monitor (Datex-Ohmeda, Madison, WI, USA). Tissue resistance was intentionally tuned so that peak pressures and delivered mechanical energy measured at airway opening were similar in Tissue and Airway Resistance models. However, measurements inside the artificial lung revealed significant differences, with Tissue resistance model yielding up to 20% higher values for delivered mechanical energy. The results indicate the need to revise current methods of calculating mechanical power delivery, which do not distinguish between tissue resistance and airway flow resistance, making it difficult to evaluate and interpret the significance of mechanical power delivery in terms of lung ventilation protectivity.
Although smartwatches are not considered medical devices, experimental validation of their accuracy in detecting hypoxemia is necessary due to their potential use in monitoring conditions manifested by a prolonged decrease in peripheral blood oxygen saturation (SpO2), such as chronic obstructive pulmonary disease, sleep apnea syndrome, and COVID-19, or at high altitudes, e.g., during sport climbing, where the use of finger-sensor-based pulse oximeters may be limited. The aim of this study was to experimentally compare the accuracy of SpO2 measurement of popular smartwatches with a clinically used pulse oximeter according to the requirements of ISO 80601-2-61. Each of the 18 young and healthy participants underwent the experimental assessment three times in randomized order-wearing Apple Watch 8, Samsung Galaxy Watch 5, or Withings ScanWatch-resulting in 54 individual experimental assessments and complete datasets. The accuracy of the SpO2 measurements was compared to that of the Radical-7 (Masimo Corporation, Irvine, CA, USA) during short-term hypoxemia induced by consecutive inhalation of three prepared gas mixtures with reduced oxygen concentrations (14%, 12%, and 10%). All three smartwatch models met the maximum acceptable root-mean-square deviation (≤4%) from the reference measurement at both normal oxygen levels and induced desaturation with SpO2 less than 90%. Apple Watch 8 reached the highest reliability due to its lowest mean bias and root-mean-square deviation, highest Pearson correlation coefficient, and accuracy in detecting hypoxemia. Our findings support the use of smartwatches to reliably detect hypoxemia in situations where the use of standard finger pulse oximeters may be limited.
- MeSH
- chronická obstrukční plicní nemoc * MeSH
- hypoxie diagnóza MeSH
- kyslík MeSH
- lidé MeSH
- oxymetrie * metody MeSH
- reprodukovatelnost výsledků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Scarcity of medical resources inspired many teams worldwide to design ventilators utilizing different approaches during the recent COVID-19 pandemic. Although it can be relatively easy to design a simple ventilator in a laboratory, a large scale production of reliable emergency ventilators which meet international standards for critical care ventilators is challenging and time consuming. The aim of this study is to propose a novel and easily manufacturable principle of gas mixing and inspiratory flow generation for mechanical lung ventilators. Two fast ON/OFF valves, one for air and one for oxygen, are used to control the inspiratory flow generation using pulse width modulation. Short gas flow pulses are smoothed by low-pass acoustic filters and do not propagate further into the patient circuit. At the same time, the appropriate pulse width modulation of both ON/OFF valves controls the oxygen fraction in the generated gas mixture. Tests focused on the accuracy of the delivered oxygen fractions and tidal volumes have proved compliance with the international standards for critical care ventilators. The concept of a simple construction using two fast ON/OFF valves may be used for designing mechanical lung ventilators and thus suitable for their rapid production during pandemics.
- MeSH
- COVID-19 * terapie MeSH
- hromadné neštěstí * MeSH
- kyslík MeSH
- lidé MeSH
- mechanické ventilátory MeSH
- pandemie MeSH
- péče o pacienty v kritickém stavu MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Outdoor breathing trials with simulated avalanche snow are fundamental for the research of the gas exchange under avalanche snow, which supports the development of the international resuscitation guidelines. However, these studies have to face numerous problems, including unstable weather and variable snow properties. This pilot study examines a mineral material perlite as a potential snow model for studies of ventilation and gas exchange parameters. Thirteen male subjects underwent three breathing phases-into snow, wet perlite and dry perlite. The resulting trends of gas exchange parameters in all tested materials were similar and when there was a significant difference observed, the trends in the parameters for high density snow used in the study lay in between the trends in dry and wet perlite. These findings, together with its stability and accessibility year-round, make perlite a potential avalanche snow model material. Perlite seems suitable especially for simulation and preparation of breathing trials assessing gas exchange under avalanche snow, and potentially for testing of new avalanche safety equipment before their validation in real snow.The study was registered in ClinicalTrials.gov on January 22, 2018; the registration number is NCT03413878.
- MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- dýchání * MeSH
- kardiopulmonální resuscitace metody MeSH
- klinické křížové studie MeSH
- laviny * MeSH
- lidé MeSH
- mladý dospělý MeSH
- oxid hlinitý * MeSH
- oxid křemičitý * MeSH
- pilotní projekty MeSH
- prospektivní studie MeSH
- sníh * MeSH
- teoretické modely MeSH
- tréninková simulace MeSH
- výměna plynů v plicích fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- Geografické názvy
- Česká republika MeSH
Terrain experiments for avalanche survival research require appropriate snow conditions, which may not be available year round. To prepare these experiments and test the protocol, it might be advantageous to test them in a laboratory with a snow model. The aim of the study was to find a material that can be used to simulate snow for studying gas exchange of a person covered with avalanche snow. Three loose porous materials (perlite, wood shavings and polystyrene) were tested in two forms—dry and moisturized. Each volunteer underwent six phases of the experiment in random order (three materials, each dry and moisturized) during experimental breathing into the tested materials. Physiological parameters and fractions of oxygen and carbon dioxide in the airways were recorded continuously. All the materials selected as possible models of the avalanche snow negatively affected gas exchange during the breathing of the volunteers in a very similar extent. The time courses of the recorded parameters were very similar and were bordered from one side by the wet perlite and from the other side by the dry perlite. Therefore, other tested materials may be substituted with perlite with an appropriate water content. From all the tested materials, perlite is the best to simulate avalanche snow because of its homogeneity, reproducibility and easy manipulation.
- MeSH
- dýchání MeSH
- hyperkapnie * MeSH
- laviny * MeSH
- lidé MeSH
- respirační insuficience MeSH
- testování materiálů MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
