Abstract
The pulse oximetry pleth trace can exhibit changes in amplitude associated with the respiratory cycle - analogous to pulsus paradoxus (Wertheim D: Arch Dis Child 2009). The presence and degree of this Respiratory Modulation of Pleth (RMP) may be a marker of increased respiratory effort, and so could be useful in assessing the severity of acute wheeze (Arnold D: Acad Emerg Med 2016; Uong A: J Emerg Med 2018).
We studied RMP in 27 young children of median (range) age 41 (12 to 82) months presenting to an emergency department with acute wheeze. Pulse oximetry pleth and respiratory inductance band (RIP) data were recorded for 5 minutes within 4 hours of starting therapy for acute wheeze. Sections with at least 20 s of regular respiratory pattern and little or no pleth artefact were assessed for presence of RMP by comparing the RIP band traces with oximetry pleth, first visually and then using custom-written software to quantify pleth variability. RMP was most evident visually in periods of regular respiration. The 8 children who had no clear RMP were all discharged from the emergency department with mean (SD) time to discharge 10.1 (5.1) hours. The 19 children with clear RMP had longer mean time to discharge of 24.8 (20.4) hours, with 6 requiring inpatient admission (3 to the high dependency unit). Our results indicate that RMP may be useful in assessing severity and outcome in acute wheeze, but RMP appeared most evident in periods of regular respiration; this suggests respiratory pattern should be considered when assessing pleth variability. Further work is needed to identify how best to quantify RMP, and its usefulness in assessing acute respiratory disease.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1206.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020