Systems and Signal Processing of Capnography as a Diagnostic Tool for Asthma Assessment

210 Pages·2022·3.323 MB·English

by  Malarvili Balakrishinan, Teo Aik Howe, Santheraleka Ramanathan, Mushikiwabeza Alexie, Om Prakash Singh

SYSTEMS AND SIGNAL PROCESSING
OF CAPNOGRAPHY AS A DIAGNOSTIC
TOOL FOR ASTHMA ASSESSMENT
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SYSTEMS AND SIGNAL PROCESSING
OF CAPNOGRAPHY AS A DIAGNOSTIC
TOOL FOR ASTHMA ASSESSMENT
M.B. MALARVILI
Assoc. Prof., P. Eng., School of Biomedical Engineering and
HealthSciences,FacultyofEngineering,UniversitiTeknologi
Malaysia, Malaysia
TEO AIK HOWE
Senior Consultant Emergency Physician, Emergency and
Trauma Department, Penang General Hospital, Malaysia
SANTHERALEKA RAMANATHAN
Researcher, School of Biomedical Engineering and Health
Sciences, Faculty of Engineering, Universiti Teknologi
Malaysia, Malaysia
MUSHIKIWABEZA ALEXIE
Assistant Lecturer, University of Rwanda (UR), College of
Science and Technology (CST)/Academic associate,
Regional Center of Excellence in Biomedical Engineering
and E-health (CEBE), Rwanda
Researcher at the School of Biomedical Engineering and
Health Sciences at Universiti Teknologi Malaysia (UTM),
Malaysia
OM PRAKASH SINGH
Researcher at the Group of Circuits and Systems, Tyndall
National Institute, University College Cork, Cork, Ireland
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Contents
Foreword ix
Preface xi
Acknowledgment xiii
Listofabbreviations xv
Listoffigures xvii
Listoftables xxi
1. The human respiratory system and overview of respiratory
diseases 1
1.1 Theprimaryroleofthehumanrespiratorysystem 1
1.2 Thebreathingprocess 2
1.3 Therespiratorydiseasesandhowtheyaffecttherespiratory
system 6
1.4 Chronicrespiratorydiseases 8
1.5 Thecommonsymptomsofrespiratorydiseases 14
1.6 Thebreathlesspatient 16
1.7 Understandingthepathophysiologyofbreathlessness 17
References 19
2. Asthma:Thediseaseandissuesinmonitoringtheasthmatic
attack 25
2.1 Asthma:theburdenofdisease 25
2.2 Thepathophysiologyofasthmaattack 29
2.3 Typesofasthma 31
2.4 Classificationinchronicasthma 34
2.5 Symptomsandsignsofasthma 35
2.6 Assessmentofasthma 37
2.7 Treatmentmodalitiesfortheasthmaticattack 40
2.8 Problemswiththemonitoringofasthmaticpatients 41
2.9 Iscapnographyanidealmodeofmonitoringforasthmatic
attacks? 42
2.10 Capnographicwaveformindices 45
References 47
3. Current tools for assessment of asthma 51
3.1 Diagnosisofasthma:commontechniquesandlimitations 51
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3.2 Capnography:anewapproachforadiagnosisofasthma 67
3.3 Typesofcapnographs 69
References 71
4. Capnography: measurement ofexpired carbon dioxide 75
4.1 Carbondioxideproductionandremovalfromhumanbody 75
4.2 Overviewofpulmonarygasexchange 77
4.3 Ventilation/perfusioninequalities 80
4.4 Measurementofcarbondioxide 81
4.5 Timebasedcapnogramandinterpretations 88
4.6 Clinicalinterpretationofcapnogram 97
References 97
5. Analysis ofcapnogram using signal processing techniques 101
5.1 EarlystudiesonexpiredCO signal(1960e90) 101
2
5.2 Capnogramfeatures 102
5.3 Oncapnogramasfeatureforasthmadetectionalgorithm 118
References 126
6. Designof carbon dioxide sensor for capnography 131
6.1 Evolutionofcarbondioxidesensing 131
6.2 Carbondioxidesensors 133
6.3 OpticalCO sensors 134
2
6.4 ElectrochemicalCO sensors 135
2
6.5 MetaloxideCO sensors 136
2
6.6 Sol-gelCO sensors 137
2
6.7 PolymerbasedCO sensor 137
2
6.8 NASICONCO sensors 138
2
6.9 ColorimetricCO sensors 138
2
6.10 WetconductometricCO sensors 139
2
6.11 Stow-SeveringhauselectrodeeISFETCO sensors 140
2
6.12 InfraredCO sensors 141
2
References 149
7. Designof carbon dioxide measurement device for asthma
monitoring 157
7.1 Respiratorygasmonitoringstandard:ISO21647 157
7.2 Currentstandardforrespiratorygasmonitoring 158
Contents vii
7.3 ISO21647basedcapnographyperformancemeasures 160
7.4 AvailabletechnologyforthedevelopmentofCO measurement
2
device 168
7.5 DesignofCO measurementtool:anoverview 169
2
7.6 RealtimehumanrespirationCO measurementdevice 173
2
References 176
Index 183
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Foreword
Asthma is a chronic inflammatory disorder that attacks the airways of the
lungs. Asthmatic patients mostly experience persistent shortness of breath,
wheezing, and chest tightness. Traditionally, asthma is detected based on
physicalassessmentfollowedbypulmonaryfunctiontest(namelyspirometry
orpeakflowmeter)toconfirmtheresults.Thesetestsareeffortdependent.
Capnography is a reliable alternative method for diagnosing asthma.
This book provides an overview of the respiratory system and its disor-
ders, a substantial explanation of asthma, existing assessment methods, and
limitations. Following that, this book delivers a detailed description of the
design of interpretations of capnography as an alternative and advanced
way for assessing and managing asthma. Finally, this book covers advances
intheassessmentofasthmawithmuchfocusonthecurrentlydevelopedsys-
tem and signal processing methods using expired carbon dioxide (CO ).
2
I congratulate the authors for applying their biomedical engineering
knowledge to develop new systems and signal processing methods using
expired carbon dioxide to provide updated information related to asthma
and its new assessment methods. In addition, this book describes computa-
tional and transmission algorithms of capnographythat would be thefoun-
dation for future developments. The extensive and rare information
presentedbytheauthors willalsobebeneficialtotheresearchers,academi-
cians,students,andhealthcareproviderswhotakecareofasthmaticpatients.
Bhavani Shankar Kodali, MD
Professor of Anesthesiology
University of Maryland School of Medicine
Date: February 24, 2022
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