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 该R21申请提出了一种新型非侵入式实时呼吸传感器的使用- 脑瘫患儿的肺功能（PF）是什么？目前，标准 肺功能的测量，如肺量测定和峰值流量计，对于儿童和那些严重的 因此，他们的遵守率很低。网络RIP不需要用户积极参与， 可以被动地测量PF。它由两个感应带组成，佩戴在胸部和腹部， 用呼吸电感测量和区分呼吸性和胸式呼吸 体积描记法（RIP）。在一个小型的胸戴式装置上记录和分析读数， 传输到iPad。呼吸功RIP产生呼吸功（WOB）指数，其包括相位角 胸部和腹部之间;通过胸腔呼吸的百分比;呼吸率;以及 呼吸指数该传感器需要很少的时间来设置和读数提供瞬间。 WOB指数为肺部疾病的诊断和治疗提供了一个筛选工具， 肺炎和呼吸道疾病，并有可能作为脊柱侧凸的儿童高， CP级。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）已经证明， 建议的PF方法在重症监护、急诊科、 房间和神经肌肉诊所 对该领域的影响将是有一种简单快速的方法来测量儿童的肺功能 和成人重度CP，并将其与功能和脊柱侧凸严重程度的测量相关联， 脊柱侧凸在CP中常见，其对肺功能的影响尚不清楚。运动功能的测量分为 根据粗大运动功能分类系统（GMFCS），从I级至V级，残疾恶化 从I型接近正常步态到V型完全使用轮椅，该项目将解决GMFCS水平 IV和V包括使用轮椅的人。两个具体目标是：a）衡量非生产性劳动力指数， 对使用轮椅的CP儿童（GMFCS IV、V级）进行有创性地使用RIPRIP传感器， 验证使用WOB指数作为肺功能障碍的筛查试验。2)确定相关 在250名CP儿童中， 轮椅（GMFCS IV、V级）。拟议的研究是创新的，因为这种RIP技术迄今 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，减轻患者的压力，减少实验室测试， 显像总的来说，我们希望这些临床研究的结果将大大增加肺部治疗 在CP中。