The REMORA study. Respiratory Rate Monitoring In Patients Receiving Procedural Sedation And Analgesia For Upper Gastrointestinal Endoscopy.

Verheul, M. (Milou) (2015) The REMORA study. Respiratory Rate Monitoring In Patients Receiving Procedural Sedation And Analgesia For Upper Gastrointestinal Endoscopy. thesis, Medicine.

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Abstract

Background The Nellcor 2.0 is a new non-invasive monitor, which measures the oxygen saturation using a finger sensor and calculates the respiratory rate (RRoxi) based on the plethysmogram, a curve which reflects the amount of vascular filling. The aim of this study was to investigate the clinical feasibility of implementation of the Nellcor 2.0 in patients receiving procedural sedation and analgesia (PSA) for upper gastrointestinal endoscopy, and to determine the level of agreement with the capnography waveform based respiratory rate as gold standard. Method Twenty-four patients undergoing upper gastrointestinal endoscopy were monitored during the administration of PSA. The acquired respiratory data of the Nellcor 2.0 (RRoxi) were compared to the simultaneously acquired end-tidal CO2 reference rate (RRETCO2). Results A total of 1054 minutes of respiratory data were collected. The median percentage of monitored procedure time the Nellcor 2.0 did not report respiratory rate was 15.5 % (8.6 – 27.7 %), yielding a total of 885 paired observations. The mean measured respiratory rate for the reference method was 12.4 brpm, ranging from 0 to 36 brpm. Mean difference between respiratory rate measurements ± standard deviation was 5.78 ± 8.58 brpm, with 95 % limits of agreement from – 11.03 to 22.59 brpm. The linear correlation coefficient of the regression analysis between the average of measured respiratory rate of both monitors and the difference was – 0.55 (p < 0.0001). Additional analyses were performed, distinguishing between respiratory rates from 4 to 11 brpm and respiratory rates above 12 brpm. The mean difference between measurements of respiratory rates from 4 to 11 brpm was 1.71 ± 3.00 brpm, with 95 % limits of agreement from – 4.17 to 7.60 brpm. For higher respiratory rates the mean difference was – 0.50 ± 3.18 brpm, with 95 % limits of agreement from – 5.72 to 6.73 brpm. Conclusion The results of this study suggest that the Nellcor 2.0 is not clinical feasible in the setting of patients receiving procedural sedation and analgesia for upper gastrointestinal endoscopies. The agreement between RRoxi and RRETCO2 decreased along with decreasing respiratory rates.

Item Type:	Thesis (Thesis)
Supervisor name:	Bles, Drs. C. and Deventer Ziekenhuis and Touw, Drs. Hugo and Boer, Dr. C. and VUmc Amsterdam
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:45
Last Modified:	25 Jun 2020 10:45
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/648

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