Effort and work-of-breathing parameters strongly correlate with increased resistance in an animal model

Background: Effort of Breathing (EOB) calculations may be a reliable alternative to Work of Breathing (WOB) calculations in which Respiratory Inductance Plethysmography (RIP) replaces spirometry. We sought to compare EOB and WOB measurements in a nonhuman primate model of increasing extrathoracic inspiratory resistance simulating upper airway obstruction (UAO).Methods: RIP, spirometry, and esophageal manometry were measured in spontaneously breathing, intubated Rhesus monkeys utilizing 11 calibrated resistors randomly applied for 2-min. EOB was calculated breath-by-breath as Pressure Rate Product (PRP) and Pressure Time Product (PTP). WOB was calculated from the Pressure-Volume curve based on spirometry (WOBSPIR) or RIP flow (WOBRIP).Results: WOB, PRP and PTP showed similar linear increases when exposed to higher levels of resistive loads. When comparing WOBSPIR to WOBRIP, a similar strong correlation was seen for both signals as resistance increased and there were no statistically significant differences.Conclusion: EOB and WOB parameters utilizing esophageal manometry and RIP, independent of spirometry, showed a strong correlation as a function of increasing inspiratory resistance in nonhuman primates. This allows several potential monitoring possibilities for non-invasively ventilated patients or situations where spirometry is not available. Impact: EOB and WOB parameters showed a strong correlation as a function of increasing inspiratory resistance in nonhuman primates.There was a strong correlation between spirometry-based WOB versus RIP-based WOB.To date, it has remained untested as to whether EOB is a reliable alternative for WOB and if RIP can replace spirometry in these measurements.Our results enable additional potential monitoring possibilities for non-invasively ventilated patients or situations where spirometry is not available.Where spirometry is not available, there is no need to apply a facemask post extubation to a spontaneously breathing, non-intubated infant to make objective EOB measurements.</p

Seriation and Multidimensional Scaling: A Data Analysis Approach to Scaling Asymmetric Proximity Matrices

A number of model-based scaling methods have been developed that apply to asymmetric proximity matrices. A flexible data analysis approach is pro posed that combines two psychometric procedures— seriation and multidimensional scaling (MDS). The method uses seriation to define an empirical order ing of the stimuli, and then uses MDS to scale the two separate triangles of the proximity matrix defined by this ordering. The MDS solution con tains directed distances, which define an "extra" dimension that would not otherwise be portrayed, because the dimension comes from relations between the two triangles rather than within triangles. The method is particularly appropriate for the analysis of proximities containing temporal information. A major difficulty is the computa tional intensity of existing seriation algorithms, which is handled by defining a nonmetric seriation algorithm that requires only one complete itera tion. The procedure is illustrated using a matrix of co-citations between recent presidents of the Psychometric Society.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline