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Sensors (Basel, Switzerland) Nov 2020Respiratory rate is a fundamental vital sign that is sensitive to different pathological conditions (e.g., adverse cardiac events, pneumonia, and clinical deterioration)... (Review)
Review
Respiratory rate is a fundamental vital sign that is sensitive to different pathological conditions (e.g., adverse cardiac events, pneumonia, and clinical deterioration) and stressors, including emotional stress, cognitive load, heat, cold, physical effort, and exercise-induced fatigue. The sensitivity of respiratory rate to these conditions is superior compared to that of most of the other vital signs, and the abundance of suitable technological solutions measuring respiratory rate has important implications for healthcare, occupational settings, and sport. However, respiratory rate is still too often not routinely monitored in these fields of use. This review presents a multidisciplinary approach to respiratory monitoring, with the aim to improve the development and efficacy of respiratory monitoring services. We have identified thirteen monitoring goals where the use of the respiratory rate is invaluable, and for each of them we have described suitable sensors and techniques to monitor respiratory rate in specific measurement scenarios. We have also provided a physiological rationale corroborating the importance of respiratory rate monitoring and an original multidisciplinary framework for the development of respiratory monitoring services. This review is expected to advance the field of respiratory monitoring and favor synergies between different disciplines to accomplish this goal.
Topics: Delivery of Health Care; Exercise; Humans; Monitoring, Physiologic; Respiratory Rate; Sports Medicine; Vital Signs
PubMed: 33182463
DOI: 10.3390/s20216396 -
The Journal of Pain 2020Slow deep breathing (SDB) is commonly employed in the management of pain, but the underlying mechanisms remain equivocal. This study sought to investigate effects of...
Slow deep breathing (SDB) is commonly employed in the management of pain, but the underlying mechanisms remain equivocal. This study sought to investigate effects of instructed breathing patterns on experimental heat pain and to explore possible mechanisms of action. In a within-subject experimental design, healthy volunteers (n = 48) performed 4 breathing patterns: 1) unpaced breathing, 2) paced breathing (PB) at the participant's spontaneous breathing frequency, 3) SDB at 6 breaths per minute with a high inspiration/expiration ratio (SDB-H), and 4) SDB at 6 breaths per minute with a low inspiration/expiration ratio (SDB-L). During presentation of each breathing pattern, participants received painful heat stimuli of 3 different temperatures and rated each stimulus on pain intensity. Respiration, heart rate, and blood pressure were recorded. Compared to unpaced breathing, participants reported less intense pain during each of the 3 instructed breathing patterns. Among the instructed breathing patterns, pain did not differ between PB and SDB-H, and SDB-L attenuated pain more than the PB and SDB-H patterns. The latter effect was paralleled by greater blood pressure variability and baroreflex effectiveness index during SDB-L. Cardiovascular changes did not mediate the observed effects of breathing patterns on pain. PERSPECTIVES: SDB is more efficacious to attenuate pain when breathing is paced at a slow rhythm with an expiration that is long relative to inspiration, but the underlying mechanisms remain to be elucidated.
Topics: Adult; Blood Pressure; Breathing Exercises; Electrocardiography; Female; Heart Rate; Humans; Male; Pain Management; Pain Measurement; Respiratory Rate; Time Factors; Young Adult
PubMed: 31978501
DOI: 10.1016/j.jpain.2019.12.010 -
Complementary Therapies in Medicine May 2023Slow breathing techniques are commonly used to reduce stress. While it is believed by mind-body practitioners that extending the exhale time relative to inhale increases... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Slow breathing techniques are commonly used to reduce stress. While it is believed by mind-body practitioners that extending the exhale time relative to inhale increases relaxation, this has not been demonstrated.
METHODS
We conducted a 12-week randomized, single-blinded trial among 100 participants to compare if yoga-based slow breathing with an exhale greater inhale versus an exhale equals inhale produces measurable differences in physiological and psychological stress among healthy adults.
RESULTS
Participants mean individual instruction attendance was 10.7 ± 1.5 sessions out of 12 offered sessions. The mean weekly home practice was 4.8 ± 1.2 practices per week. There was no statistical difference between treatment groups for frequency of class attendance, home practice, or achieved slow breathing respiratory rate. Participants demonstrated fidelity to assigned breath ratios with home practice as measured by remote biometric assessments through smart garments (HEXOSKIN). Regular slow breathing practice for 12 weeks significantly reduced psychological stress as measured by PROMIS Anxiety (-4.85 S.D. ± 5.53, confidence interval [-5.60, -3.00], but not physiological stress as measured by heart rate variability. Group comparisons showed small effect size differences (d = 0.2) with further reductions in psychological stress and physiological stress from baseline to 12 weeks for exhale greater than inhale versus exhale equals inhale, however these differences were not statistically significant.
CONCLUSION
While slow breathing significantly reduces psychological stress, breath ratios do not have a significant differential effect on stress reduction among healthy adults.
Topics: Adult; Humans; Respiratory Rate; Yoga; Meditation
PubMed: 36871835
DOI: 10.1016/j.ctim.2023.102937 -
Journal of Mathematical Biology Oct 2022All schoolchildren know how often they breathe, but even experts don't know exactly why. The aim of this publication is to develop a model of the resting spontaneous...
All schoolchildren know how often they breathe, but even experts don't know exactly why. The aim of this publication is to develop a model of the resting spontaneous breathing rate using physiological, physical and mathematical methods with the aid of the principle that evolution pushes physiology in a direction that is as economical as possible. The respiratory rate then follows from an equation with the parameters [Formula: see text]-production rate of the organism, resistance, static compliance and dead space of the lungs, the inspiration duration: expiration duration - ratio and the end-expiratory [Formula: see text] fraction. The derivation requires exclusively secondary school mathematics. Using the example of an adult human or a newborn child, data from the literature then result in normal values for their breathing rate at rest. The reason for the higher respiratory rate of a newborn human compared to an adult is the relatively high [Formula: see text]-production rate together with the comparatively low compliance of the lungs. A side result is the fact that the common alveolar pressure throughout the lungs and the common time constant is a consequence of the economical principle as well. Since the above parameters are not human-specific, there is no reason to assume that the above equation could not also be applicable to many animals breathing through lungs within a thorax, especially mammals. Not only physiology and biology, but also medicine, could benefit: Applicability is being discussed in pulmonary function diagnostics, including pathophysiology. However, the present publication only claims to be a theoretical concept of the spontaneous quiet breathing rate. In the absence of comparable animal data, this publication is intended to encourage further scientific tests.
Topics: Humans; Adult; Animals; Infant, Newborn; Child; Respiratory Rate; Lung; Mammals
PubMed: 36282355
DOI: 10.1007/s00285-022-01790-8 -
Journal of Neurophysiology Apr 2022In a recent article published in titled "Sensitivity to changes in rate of heartbeats as a measure of interoceptive ability," Larsson et al. ( 126: 1799-1813, 2021)... (Review)
Review
In a recent article published in titled "Sensitivity to changes in rate of heartbeats as a measure of interoceptive ability," Larsson et al. ( 126: 1799-1813, 2021) introduce a new method to evaluate the interoceptive ability and report a surprising tendency in humans to perceive fewer heartbeats during spontaneous increases in resting heart rate. The authors argue that this result reflects a reduction in the strength of the heartbeat during the inspiration periods. Here, we discuss this finding and propose a complementary interpretation grounded on consciousness research and an emerging literature showing the influence of the breathing phase on perception and brain activity at rest.
Topics: Awareness; Consciousness; Heart Rate; Humans; Interoception; Respiration; Respiratory Rate
PubMed: 35294271
DOI: 10.1152/jn.00027.2022 -
The Journal of Allergy and Clinical... Nov 2023Global warming has direct and indirect effects, as well as short- and long-term impacts on the respiratory and skin barriers. Extreme temperature directly affects the... (Review)
Review
Global warming has direct and indirect effects, as well as short- and long-term impacts on the respiratory and skin barriers. Extreme temperature directly affects the airway epithelial barrier by disrupting the structural proteins and by triggering airway inflammation and hyperreactivity. It enhances tidal volume and respiratory rate by affecting the thermoregulatory system, causing specific airway resistance and reflex bronchoconstriction via activation of bronchopulmonary vagal C fibers and upregulation of transient receptor potential vanilloid (TRPV) 1 and TRPV4. Heat shock proteins are activated under heat stress and contribute to both epithelial barrier dysfunction and airway inflammation. Accordingly, the frequency and severity of allergic rhinitis and asthma have been increasing. Heat activates TRPV3 in keratinocytes, causing the secretion of inflammatory mediators and eventually pruritus. Exposure to air pollutants alters the expression of genes that control skin barrier integrity and triggers an immune response, increasing the incidence and prevalence of atopic dermatitis. There is evidence that extreme temperature, heavy rains and floods, air pollution, and wildfires increase atopic dermatitis flares. In this narrative review, focused on the last 3 years of literature, we explore the effects of global warming on respiratory and skin barrier and their clinical consequences.
Topics: Humans; Dermatitis, Atopic; Global Warming; Respiratory Rate; Rhinitis, Allergic; Inflammation
PubMed: 37689250
DOI: 10.1016/j.jaci.2023.09.001 -
Respiratory Physiology & Neurobiology Aug 2019Respiratory frequency plasticity is a long-lasting increase in breathing frequency due to a perturbation. Mechanisms underlying respiratory frequency are poorly... (Review)
Review
Respiratory frequency plasticity is a long-lasting increase in breathing frequency due to a perturbation. Mechanisms underlying respiratory frequency are poorly understood, and there is little evidence of frequency plasticity in neonates. This hybrid review/research article discusses available literature regarding frequency plasticity and highlights potential research opportunities. Also, we include data demonstrating a model of frequency plasticity using isolated neonatal rat brainstem-spinal cord preparations. Specifically, substance P (SubP) application induced a long-lasting (>60 min) increase in spontaneous respiratory motor burst frequency, particularly in brainstem-spinal cords with the pons attached; there were no male/female differences. SubP-induced frequency plasticity is dependent on the application pattern, such that intermittent (rather than sustained) SubP applications induce more frequency plasticity. SubP-induced frequency plasticity was blocked by a neurokinin-1 receptor antagonist. Thus, the newborn rat respiratory control system has the capacity to express frequency plasticity. Identifying mechanisms that induce frequency plasticity may lead to novel methods to safely treat breathing disorders in premature and newborn infants.
Topics: Animals; Animals, Newborn; Brain Stem; Growth and Development; Neuronal Plasticity; Neurotransmitter Agents; Rats; Respiratory Rate; Spinal Cord; Substance P
PubMed: 31055188
DOI: 10.1016/j.resp.2019.04.014 -
Sensors (Basel, Switzerland) Feb 2021There is considerable interest in the noncontact monitoring of patients as it allows for reduced restriction of patients, the avoidance of single-use consumables and... (Review)
Review
There is considerable interest in the noncontact monitoring of patients as it allows for reduced restriction of patients, the avoidance of single-use consumables and less patient-clinician contact and hence the reduction of the spread of disease. A technology that has come to the fore for noncontact respiratory monitoring is that based on depth sensing camera systems. This has great potential for the monitoring of a range of respiratory information including the provision of a respiratory waveform, the calculation of respiratory rate and tidal volume (and hence minute volume). Respiratory patterns and apneas can also be observed in the signal. Here we review the ability of this method to provide accurate and clinically useful respiratory information.
Topics: Humans; Monitoring, Physiologic; Respiratory Rate; Tidal Volume
PubMed: 33561970
DOI: 10.3390/s21041135 -
Journal of Clinical Monitoring and... Dec 2022Accurate measurement of respiratory rate (RR) in neonates is challenging due to high neonatal RR variability (RRV). There is growing evidence that RRV measurement could...
Accurate measurement of respiratory rate (RR) in neonates is challenging due to high neonatal RR variability (RRV). There is growing evidence that RRV measurement could inform and guide neonatal care. We sought to quantify neonatal RRV during a clinical study in which we compared multiparameter continuous physiological monitoring (MCPM) devices. Measurements of capnography-recorded exhaled carbon dioxide across 60-s epochs were collected from neonates admitted to the neonatal unit at Aga Khan University-Nairobi hospital. Breaths were manually counted from capnograms and using an automated signal detection algorithm which also calculated mean and median RR for each epoch. Outcome measures were between- and within-neonate RRV, between- and within-epoch RRV, and 95% limits of agreement, bias, and root-mean-square deviation. Twenty-seven neonates were included, with 130 epochs analysed. Mean manual breath count (MBC) was 48 breaths per minute. Median RRV ranged from 11.5% (interquartile range (IQR) 6.8-18.9%) to 28.1% (IQR 23.5-36.7%). Bias and limits of agreement for MBC vs algorithm-derived breath count, MBC vs algorithm-derived median breath rate, MBC vs algorithm-derived mean breath rate were - 0.5 (- 2.7, 1.66), - 3.16 (- 12.12, 5.8), and - 3.99 (- 11.3, 3.32), respectively. The marked RRV highlights the challenge of performing accurate RR measurements in neonates. More research is required to optimize the use of RRV to improve care. When evaluating MCPM devices, accuracy thresholds should be less stringent in newborns due to increased RRV. Lastly, median RR, which discounts the impact of extreme outliers, may be more reflective of the underlying physiological control of breathing.
Topics: Infant, Newborn; Humans; Respiratory Rate; Kenya; Capnography; Monitoring, Physiologic; Respiration
PubMed: 35332406
DOI: 10.1007/s10877-022-00840-2 -
Respiratory Medicine Dec 2023Respiratory rate is a commonly used vital sign with various clinical applications. It serves as a crucial marker of acute health issues and any significant alteration in...
PURPOSE
Respiratory rate is a commonly used vital sign with various clinical applications. It serves as a crucial marker of acute health issues and any significant alteration in respiratory rate may be an early warning sign of major issues such as infections in the respiratory tract, respiratory failure, or cardiac arrest. Timely recognition of changes in respiratory rate enables prompt medical action, while neglecting to detect a change may lead to adverse patient outcomes. Here, we report on the performance of respiratory rate determined using a depth sensing camera system (RR) which allows for continuous, non-contact 'touchless' monitoring of this important vital sign.
METHODS
Thirty adult volunteers undertook a range of set breathing rates to cover a target breathing range of 4-40 breaths/min. Depth information was acquired from the torso region of the subjects using an Intel D415 RealSense camera positioned above the bed. The depth information was processed to generate a respiratory signal from which RR was calculated. This was compared to a manually scored capnograph reference (RR).
RESULTS
An overall RMSD accuracy of 0.77 breaths/min was achieved across the target respiratory rate range with a corresponding bias of 0.05 breaths/min. This corresponded to a line of best fit given by RR = 1.01 x RR - 0.22 breaths/min with an associated high degree of correlation (R = 0.997). A breakdown of the performance with respect to sub-ranges corresponding to respiratory rates or ≤7, >7-10, >10-20, >20-30, >30 breaths/min all exhibited RMSD accuracies of less than 1.00 breaths/min. We also had the opportunity to test the performance of spontaneous breathing of the subjects which occurred during the study and found an overall RMSD accuracy of 1.20 breaths/min with corresponding accuracies ≤1.30 breaths/min across each of the individual sub-ranges.
CONCLUSIONS
We have conducted an investigative study of a prototype depth sensing camera system for the non-contact monitoring of respiratory rate. The system achieved good performance with high accuracy across a wide range of rates including both clinically important high and low rates.
Topics: Adult; Humans; Respiratory Rate; Respiration; Respiratory System; Technology; Monitoring, Physiologic
PubMed: 37993024
DOI: 10.1016/j.rmed.2023.107463