Sains Malaysiana 45(7)(2016): 1121–1129

Development of a Novel Device for Monitoring Incentive Spirometry Performance

(Pembangunan Peranti Novel bagi Pemantauan Prestasi Spirometri Insentif)

AQILAH LEELA T. NARAYANAN¹*, MUHAMMAD AKMAL AYOB², NORAYATI NORDIN²,

ARIEF RUHULLAH A. HARRIS³ & EKO SUPRIYANTO²

¹Faculty of Biosciences and Medical Engineering, UniversitiTeknologi Malaysia, 81310 Johor Bahru, Johor Darul Takzim, Malaysia

²IJN-UTM Cardiovascular Engineering Centre, Faculty of Biosciences and Medical Engineering

UniversitiTeknologi Malaysia, 81310 Johor Bahru, Johor Darul Takzim, Malaysia

³Centre of Biomedical Engineering, Faculty of Biosciences and Medical Engineering, UniversitiTeknologi Malaysia, 81310 Johor Bahru, Johor Darul Takzim, Malaysia

Diserahkan: 5 Julai 2015/Diterima: 16 Februari 2016

ABSTRACT

Lung atelectasis caused by shallow breathing patterns is common after cardiac, thoracic and upper abdominal surgeries. A common method used to address this problem is to encourage patients to perform breathing exercises using incentive spirometers in the postoperative period. However, to be effective, this procedure must be repeated regularly so that adequate lung volumes can be maintained to prevent atelectasis. Current models of single-use, low-cost incentive spirometers do not have features that can track and store data on breathing exercises. This makes it difficult to monitor patients’ breathing exercises effectively. We present here a device designed to be interfaced with the Spiro-ball incentive spirometer and programmed to monitor the incentive spirometry performance. Laboratory based validation performed indicate that there were no significant differences between the value obtained from the device and manual reading; p-value > 0.05 and root-mean-square error (RMSE) is 3.882. The device was able to retrieve and display pertinent data on incentive spirometry performance. It was also able to correctly track and register random sets of inspiration data through different dates and timelines. Being a separate entity which is reusable, it does not add to the cost of the single-use incentive spirometer.

Keywords: Breathing exercise; data collection; incentive spirometry

ABSTRAK

Atelektasis paru-paru yang berpunca daripada pernafasan yang cetek adalah satu kebiasaan selepas pembedahan jantung, toraks dan abdomen bahagian atas. Kebiasaannya, kaedah yang digunakan untuk mengatasi masalah ini adalah menggalakkan pesakit menjalankan latihan pernafasan menggunakan spirometer insentif dalam tempoh pasca pembedahan. Walau bagaimanapun, untuk ia menjadi efektif, prosedur in perlu diulang secara berterusan supaya isi padu paru-paru yang mencukupi dapat dikekalkan untuk mengelakkan atelektasis paru-paru terjadi. Model semasa bagi spirometer insentif adalah sekali guna dan kos rendah serta tidak mempunyai ciri-ciri mengesan dan merekod data untuk latihan pernafasan. Hal ini menyukarkan proses pemantauan latihan pernafasan yang dilakukan oleh pesakit secara efektif. Kajian ini membentangkan alat yang direka untuk diaplikasikan bersama Spiro-ball spirometer insentif dan diprogramkan untuk memantau prestasi insentif spirometri. Validasi menerusi makmal yang dijalankan menunjukkan bahawa tiada perbezaan ketara antara nilai yang diperoleh daripada alat ini dan bacaan secara manual; nilai p lebih besar daripada 0.05 dan punca min ralat kuasa dua (RMSE) adalah 3.882. Alat ini berupaya untuk mendapatkan kembali dan memaparkan data prestasi insentif spirometri. Ia juga mampu mengesan dan menyimpan set data yang rawak melalui tarikh dan masa yang berbeza. Alat ini merupakan entiti yang berasingan daripada spirometer insentif, oleh yang demikian ia tidak menambah kos asal spirometer insentif sekali guna.

Kata kunci: Latihan pernafasan; pengumpulan data; spirometer insentif

RUJUKAN

Brown, S.D. & Walters, M.R. 2012. Patients with rib fractures - use of incentive spirometry volumes to guide care. J. Trauma Nurs. 19(2): 89-91.

Carayon, P. & Gürses, A.P. 2005. A human engineering conceptual framework of nursing workload and patient safety in intensive care units. Intensive Crit. Care Nurs. 21(5): 284-301.

Carvalho, C.R.F., Paisani, D.M. & Lunardi, A.C. 2011. Incentive spirometry in major surgeries: a systematic review. Rev. Bras. Fisioter. 15(5): 343-350.

do Nascimento Junior, P., Módolo, N.S., Andrade, S., Guimarães, M.M., Braz, L.G. & El Dib, R. 2014. Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. Cochrane Database Syst Rev. 2: CD006058.

Duggan, M. & Kavanagh, B.P. 2010. Perioperative modifications of respiratory function. Best Pract. Res. Clin. Anaesthesiol. 24(2): 145-155.

Duggan, M. & Kavanagh, B.P. 2005. Pulmonary atelectasis - a pathogenic perioperative entity. Anesthesiology 102(4): 838-854.

Gale, G.D. & Sanders, D.E. 1977. The Bartlett-Edwards incentive spirometer: a preliminary assessment of its use in the prevention of atelectasis after cardio-pulmonary bypass. Can. Anaesth. Soc. J. 24(3): 408-416.

Glover, D.W. 2010. The History of Respiratory Therapy - Discovery and Evolution. Bloomington, Indiana: Author House.

Gosselink, R., Schrever, K., Cops, P., Witvrouwen, H., De, L.P., Troosters, T., Lerut, A., Deneffe, G. & Decramer, M. 2000. Incentive spirometry does not enhance recovery after thoracic surgery. Crit. Care Med. 28(3): 679-683.

O’ Donohue Jr. W.J. 1992. Postoperative pulmonary complications. When are preventive and therapeutic measures necessary? Postgrad. Med. 91(3): 167-170.

Overend, T.J., Anderson, C.M., Lucy, S.D., Bhatia, C., Jonsson, B. & Timmermans, C. 2001. The effect of incentive spirometry on postoperative complications; a systematic review. Chest 120(3): 971-978.

Owens, M.W., Milligan, S.A. & Eggerstedt, J.M. 2005. Trauma, Surgery, and Perioperative Management. In Essentials of Pulmonary and Critical Care Medicine. 5th edition, edited by George, R.B., Light, R.W., Matthay, M.A., Matthay, R.A., Philadelphia, Pennsylvania: Lippincott Williams and Wilkins. pp. 564-588.

Restrepo, R.D., Wettstein, R., Wittnebel, L. & Tracy, M. 2011. AARC clinical practice guideline. Respir. Care 56(10): 1600-1604.

Shander, A., Fleisher, L.A., Barie, P.S., Bigatello, L.M., Sladen, R.N. & Watson, C.B. 2011. Clinical and economic burden of postoperative pulmonary complications: patient safety summit on definition, risk-reducing interventions, and preventive strategies. Crit. Care Med. 39(9): 2163-2172.

Sharp. 2002. Distance measuring sensor unit. Distance=4-30cm, Analog Output type. GP2Y0A41SK0F DATASHEET.

Thoren, L. 1954. Postoperative pulmonary complications: observations on their prevention by means of physiotherapy. Acta Chir. Scand. 107(2): 193-205.

Warner, D.O. 2000. Preventing postoperative pulmonary complications: the role of the anaesthesiologist. Anesthesiology 92(5): 1467-1472.

White, G.C. 2014. Equipment Theory for Respiratory Care. 5th ed. Stamford, CT: Cengage Learning.

Wirral Community. 2012. Policy for single use medical devices infection prevention and control policy no. 6 version 1. http://www.wirralct.nhs.uk/.../ ICP6SingleUseMedicalDevicesPolicyNov12.pdf.

Wynne, R. & Botti, M. 2004. Postoperative pulmonary dysfunction in adults after cardiac surgery with cardiopulmonary bypass: clinical significance and implications for practice. Am. J. Crit. Care 13(5): 384-393.

*Pengarang untuk surat-menyurat; email: aqilah@biomedical.utm.my