Non-Invasive Measurement of Pulmonary Dysfunction in Children with Cerebral Palsy

脑瘫儿童肺功能障碍的无创测量

• 批准号: 10646934
• 负责人: TARIQ RAHMAN
• 金额: $ 22.54万
• 依托单位: ALFRED I. DU PONT HOSP FOR CHILDREN
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10646934
• 关键词: Abdomen; Accident and Emergency department; Address; Adult; Biomedical Engineering; Breathing; Cerebral Palsy; Chest; Child; Childhood; Classification; Clinic; Clinical Research; Coughing; Data; Diagnosis; Diagnostic; Effectiveness; Ensure; Failure; Flowmeters; Functional disorder; Gait; Goals; Image; Incidence; Institution; Intensive Care; Laboratories; Link; Live Birth; Lung; Lung diseases; Managed Care; Measurement; Measures; Mechanics; Methodology; Motor; Mucous body substance; Operating Rooms; Outcome; Patients; Persons; Phase; Plethysmography; Pneumonia; Qualifying; Research; Research Personnel; Respiratory Diaphragm; Respiratory Insufficiency; Respiratory Muscles; Respiratory distress; Respiratory physiology; Risk; Scientist; Screening procedure; Severities; Sleep; Spirometry; Stress; Symptoms; System; Techniques; Technology; Testing; Time; Visual; Walking; Wheelchairs; Work of Breathing; awake; cohort; disability; experience; indexing; innovation; neuromuscular; novel; pulmonary function; respiratory; rib bone structure; scoliosis; screening; sensor; standard measure; wireless transmission

Project Summary This R21 application proposes the utilization of a novel non-invasive real-time breathing sensor – pneuRIP- to measure pulmonary function (PF) in children with high-level cerebral palsy. Currently the standard measures of PF such as spirometry and peak flow meters are too strenuous for children and those with severe CP, as a result they have low compliance rates. The pneuRIP does not require active user participation and can passively measure PF. It consists of two inductive bands worn around the chest and abdomen that measure and differentiate diaphragmatic and chest breathing through Respiratory Inductance Plethysmography (RIP). Readings are recorded and analyzed on a small chest-worn unit and wirelessly transmitted to an iPad. The pneuRIP yields indices of work of breathing (WOB) which includes the phase angle between the chest and abdomen; percentage breathing through the ribcage; respiratory rate; and labored breathing index. This sensor takes little time to set up and readings are provided instantaneously. The WOB indices provide a screening tool for pulmonary diagnosis and treatment, decrease the risk for pneumonia and respiratory illness, and has the potential to act as a marker for scoliosis in children with high- level CP. Our research team (clinicians, basic scientists, bioengineers & therapists) has shown the effectiveness of the proposed PF methodology in both intensive care, emergency departments, operating rooms, and neuromuscular clinics. The impact on the field will be to have a simple and fast way to measure pulmonary function in children and adults with severe CP and correlate this to measures of function and scoliosis severity as the effects of scoliosis, which is common in CP, on pulmonary function is unclear. Measures of motor function are classified by the Gross Motor Functional Classification System (GMFCS), ranking from I to V, with worsening disability from near normal gait in Type I to complete wheelchair use in Type V. This project will address GMFCS levels IV and V which includes people using wheelchairs. The two specific aims are a) Measure WOB indices non- invasively using the pneuRIP sensor in children with CP who use a wheelchair (GMFCS level IV, V) and validate the use of WOB indices as a screening test for pulmonary dysfunction., 2) Determine the correlation between WOB indices and the degree of scoliosis using the pneuRIP sensor in 250 children with CP who use a wheelchair (GMFCS level IV, V). The proposed research is innovative because this RIP technology to date has not been incorporated in the diagnosis and treatment of children with CP. The advantages include provision of the diagnostic data in real-time, less stress to the patients, and a reduction in lab testing and imaging. Collectively, we expect the outcomes of these clinical studies will greatly add to pulmonary treatment in CP.

项目摘要 此R21应用建议使用新型非侵入性实时呼吸传感器的利用 - 高水平脑瘫儿童的肺部 - 测量肺功能（PF）。目前是标准 PF的措施（例如肺活量测定法和峰值流量计）对于儿童和严重的人来说太强了 CP，因此它们的合规率较低。 pneurip不需要主动用户参与，并且 可以被动测量PF。它由两个在胸部和腹部周围戴的感应带组成 测量并通过呼吸道电感来测量和区分diaphragmatic和胸部呼吸 杂质学（RIP）。在小胸部的单元和无线上记录和分析读数 传输到iPad。 Pneurip产生呼吸工作指标（WOB），包括相角 在胸部和腹部之间；通过胸腔呼吸百分比；呼吸率；和实验室 呼吸指数。该传感器几乎没有时间进行设置，并且即时提供了读数。 WOB指数为肺部诊断和治疗提供了筛查工具，降低了 肺炎和呼吸道疾病，有可能充当高脊柱侧弯的标志 级别CP。我们的研究团队（临床医生，基础科学家，生物工程师和治疗师）表明 拟议的PF方法在重症监护术，急诊室，运营中的有效性 房间和神经肌肉诊所。 对场地的影响将是具有一种简单而快速的方法来测量儿童的肺功能 以及患有严重CP的成年人，并将其与功能和脊柱侧弯严重程度的量度相关联 在CP中常见的关于肺功能的脊柱侧弯尚不清楚。运动功能的度量分类 通过总体电机功能分类系统（GMFC），从I到V的排名，遗憾的是残疾 从I型接近正常聚集到V型在坐轮椅上使用。该项目将解决GMFCS级别 IV和V，包括使用轮椅的人。这两个具体目的是a）测量WOB指数非 - 在使用轮椅的儿童中使用Pneurip传感器（GMFCS级别IV，V）和 验证使用WOB指数作为肺功能障碍的筛查测试。，2）确定相关性 在使用Pneurip传感器的250名使用CP的儿童中，WOB指数与脊柱侧弯的程度之间 轮椅（GMFCS级IV，V）。拟议的研究具有创新性，因为迄今为止的RIP技术 尚未纳入CP儿童的诊断和治疗。优点包括 实时提供诊断数据，对患者的压力较小，并减少实验室测试和 成像。总体而言，我们预计这些临床研究的结果将大大增加肺部治疗 在CP中。