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Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
Research in progress - Clinical Trial: Correlations with conventional measurements of lung function
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Research in progress - Clinical Trial: Correlations with conventional measurements of lung function

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Clinical Partners Meeting - 20/03/2012 - Trinity College, Cambridge …

Clinical Partners Meeting - 20/03/2012 - Trinity College, Cambridge

Miss Jenny Conlon- Respiratory Physiologist/ Research Assistant

Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK

Published in: Health & Medicine
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  • Brief introduction
  • To include photo of crane set-up
  • Transcript

    • 1. Research in ProgressClinical Trial: Correlations withconventional measurements of lung functionMiss Jenny Conlon- Respiratory Physiologist/ Research Assistant 1
    • 2. Conventional Measurements • Spirometry is one of the most common pulmonary function tests (PFTs) • Physiological test that measures the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled • Spirometry is performed using a spirometer device which comes in several different varieties
    • 3. Indications for Spirometry 1. Diagnostic e.g. assess pre-operative risk 2. Monitoring e.g. assess therapeutic intervention 3. Disability/ Impairment Evaluations e.g. assess patients as part of a rehabilitation programme 4. Public Health e.g. derivation of reference equations
    • 4. Key Parameters • Vital Capacity (VC) / Forced Vital Capacity (FVC) (L) VC = The maximal volume of air exhaled from a maximal inspiration FVC = VC performed with a maximally forced expiratory effort • Forced Expiratory Volume in One Second (FEV1) (L.sec -1) Maximal volume of air exhaled in the first second of a forced expiration from a position of full inspiration • Peak Expiratory Flow (PEF) (L.min -1) Maximum expiratory flow achieved from a maximum forced expiration, starting without hesitation, from the point of maximum lung inflation 4
    • 5. Spirometric Output 1. Volume-time curve
    • 6. Spirometric Output 2. Flow-volume loop
    • 7. Quality Control & Hygiene/Infection Control Test Minimal Action Interval Volume Daily Calibration check with 3-L syringe Leak Daily 3 cmH20 (0.3 kPa) constant pressure for 1 min Volume Quarterly 1-L increments with a calibrating syringe measured over entire Linearity volume range Flow Weekly Test at least 3 different flow ranges Linearity Time Quarterly Mechanical recorder check with stopwatch Software New Versions Log installation date and perform test using “known” subject 29 March 2012 7
    • 8. Spirometry Standardisation Steps 29 March 2012
    • 9. Simultaneous SLP & Spirometry Clinical Trial Title: Validation of SLP against Spirometry Sponsor: PneumaCare Limited Aim: Validate SLP by comparing tidal volume and forced expiration measurements obtained using SLP against simultaneous measurements via spirometry 29 March 2012 9
    • 10. Methodology 1. Patient recruitment, inclusion/exclusion criteria 2. Spirometer set-up 3. SLP/PneumaScan set-up ( grid positioning, grid coverage) 4. Measurements (1 x tidal breathing and ~ 3 x forced manoeuvres)
    • 11. Key Factors
    • 12. Grid Coverage Grid coverage has been classified into three areas: • Low coverage • Medium coverage • High coverage
    • 13. Low Coverage Example Projected grid not covering the abdomen, chest or sides
    • 14. Medium Coverage Example
    • 15. High Grid Coverage
    • 16. Grid Positioning Grid coverage has been classified into two areas; • Low positioning • High positioning
    • 17. Low Grid Positioning
    • 18. High Grid Positioning
    • 19. Movement• Estimated that ~10-15% of SLP volume measurements affected by patient movement• Movement during forced manoeuvres reduces the volume measured by SLP and increases the difference between SLP and spirometry data
    • 20. Key Points for Consideration • Grid coverage and position accounts for the greatest inconsistency between techniques • Poor positioning and coverage can reduce the volume significantly • Movement during forced manoeuvres reduces the volume measured by SLP and increases the difference between SLP and spirometry data
    • 21. Optimal Set-Up 29 March 2012 21
    • 22. SLP Output 29 March 2012 22
    • 23. Data Collection Total number of subjects tested = 108 Average number of data sets per subject = 4 Adults = 96 Active/previous lung disease = 53 "Healthy Others" = 43 Children (<18 years) = 12 Active/previous lung disease= 10 “Healthy Others”= 2 29 March 2012 24
    • 24. Disease Types Respiratory Disease No. of Subjects COPD 16 Asthma 12 Pneumonia 6 Bronchiectasis 4 Cystic Fibrosis 5 “Other” 20 29 March 2012 25
    • 25. Findings • Building on previous results obtained in Pilot and Trial studies with a CE marked device • Previous research: Strong correlations calculated between Spirometer and SLP data via waveform analysis for respiratory rate (r = 0.999), Vt (r = 0.967), and forced expiration (r = 0.98) • Current clinical trial: Progression to now displaying similar correlations on volume changes and flows between Spirometer and SLP data via integration and differentiation analysis
    • 26. Findings 8 FVC 7 6 SLP FVC (l) 5 4 3 2 1 y = 1.006x + 0.435 R² = 0.902 0 0 1 2 3 4 5 6 7 Spirometry FVC (l) 29 March 2012 27
    • 27. Findings 6 FEV1 5 4 SLP FEV1 (l) 3 2 y = 1.006x + 0.081 1 R² = 0.830 0 0 1 2 3 4 5 Spirometry FEV1 (l) 29 March 2012 28
    • 28. Findings Tidal Volume 2 SLP VT (l) 1 y = 1.008x + 0.015 R² = 0.814 0 0 1 2 Spirometry VT (l) 29 March 2012 29
    • 29. Findings Expiratory Time 7 6 5 SLP ET (s) 4 3 2 1 y = 0.978x + 0.116 R² = 0.875 0 0 1 2 3 4 5 6 7 Spirometry ET (s) 29 March 2012 30
    • 30. Findings Inspiratory Time 4 3 SLP IT (s) 2 1 y = 0.870x + 0.177 R² = 0.871 0 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 Spirometry IT (s) 29 March 2012 31
    • 31. Findings 7 FVC- Gender Analysis 6 5 4 SLP FVC (l) 3 Female 2 Male 1 0 0 1 2 3 4 5 6 7 Spirometry FVC (l) 29 March 2012 32
    • 32. Other Research Projects 1. Validation of SLP in non-invasive ventilated COPD patients - Patients tested ~24 hours following exacerbation/admission and at 3 day intervals until discharge - Tidal breathing measurements taken both on and off non-invasive ventilation (NIV) where possible - Measurements recorded from NIV machine during measurements (i.e. respiratory rate, tidal volume) - Rating of perceived breathlessness recorded
    • 33. Other Research Projects 2. Validation of SLP in non-ventilated neonates - Assessment of breathing patterns in new born neonates - Progression to validation of SLP in ventilated neonates - Use of alternate mount currently in development to allow placement of PneumaScan above incubator
    • 34. Set-Up
    • 35. Set-Up
    • 36. Development of Set-Up
    • 37. Summary • Solid base of data to build upon • ‘Learning process’ throughout recent data collection • Improved outcomes with focus to ‘key factors’ during measurements • Improved data collection via developments in device and software (i.e. real time system, alternate mount) • Continue to expand data collection across clinical populations
    • 38. References • Miller, et al. ‘Standardisation of Spirometry’ (2005) • Rutala, et al. ‘Infection risks associated with spirometry’ (1991) • Leeming, et al. ‘Use of filters for the control of cross-infection during pulmonary function testing’ (1993) • Miller, et al. ‘General considerations for lung function testing’ (2005) • Miller, et al. ‘Interpretative strategies for lung function tests’ (2005)
    • 39. Any Questions?

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