A new pediatric respiratory monitor that accurately measures imposed work of breathing: A validation study

Objective. A new, microprocessor-controlled respiratory monitor (model CP-100 Pediatric, Bicore Monitoring Systems, Irvine, CA) that measures imposed work of breathing and a variety of respiratory parameters for pediatric patients receiving ventilatory support has recently been developed. To validate its accuracy, measurements obtained using this monitor were compared with those obtained using conventional laboratory equipment.Methods. An in vitro lung model was used to simulate spontaneously breathing pediatric patients ranging from infancy to 10 years of age. Tidal volume, respiratory rate, and peak inspiratory flow rates were simulated in a stepwise manner. Values for imposed work, tidal volume, peak inspiratory flow rate, and change in airway pressure for both methods were compared using regression analysis.Results. The coefficients of determination (r²) describing the relationships of both methods of measuring imposed work, tidal volume, peak inspiratory flow rate, and the change in airway pressure ranged from 0.99 to 1.00, and were highly significant (p<0.001). For all measurements, bias was minimal and precision was calculated.Conclusions. Our data reveal that this pediatric respiratory monitor accurately measures imposed work of breathing, as well as tidal volume, flow rate, and airway pressure. Imposed work of breathing measurements obtained from the monitor may be used to adjust pressure support ventilation, so that the imposed work of the breathing apparatus is reduced to zero and the patient's total work of breathing is thus decreased.