Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 May 21;22(1):154.
doi: 10.1186/s12931-021-01747-3.

Use of capnography for prediction of obstruction severity in non-intubated COPD and asthma patients

Barak Pertzov  1   2 , Michal Ronen  3 , Dror Rosengarten  4   5 , Dorit Shitenberg  4   5 , Moshe Heching  4   5 , Yael Shostak  4   5 , Mordechai R Kramer  4   5
Affiliations
Observational Study

Use of capnography for prediction of obstruction severity in non-intubated COPD and asthma patients

Barak Pertzov et al. Respir Res. .

Abstract

Background: Capnography waveform contains essential information regarding physiological characteristics of the airway and thus indicative of the level of airway obstruction. Our aim was to develop a capnography-based, point-of-care tool that can estimate the level of obstruction in patients with asthma and COPD.

Methods: Two prospective observational studies conducted between September 2016 and May 2018 at Rabin Medical Center, Israel, included healthy, asthma and COPD patient groups. Each patient underwent spirometry test and continuous capnography, as part of, either methacholine challenge test for asthma diagnosis or bronchodilator reversibility test for asthma and COPD routine evaluation. Continuous capnography signal, divided into single breaths waveforms, were analyzed to identify waveform features, to create a predictive model for FEV1 using an artificial neural network. The gold standard for comparison was FEV1 measured with spirometry.

Measurements and main results: Overall 160 patients analyzed. Model prediction included 32/88 waveform features and three demographic features (age, gender and height). The model showed excellent correlation with FEV1 (R = 0.84), R2 achieved was 0.7 with mean square error of 0.13.

Conclusion: In this study we have developed a model to evaluate FEV1 in asthma and COPD patients. Using this model, as a point-of-care tool, we can evaluate the airway obstruction level without reliance on patient cooperation. Moreover, continuous FEV1 monitoring can identify disease fluctuations, response to treatment and guide therapy.

Trial registration: clinical trials.gov, NCT02805114. Registered 17 June 2016, https://clinicaltrials.gov/ct2/show/NCT02805114.

Keywords: Airway obstruction; Asthma; COPD; Capnography; FEV1; Model; Neural network.

PubMed Disclaimer

Conflict of interest statement

This study was sponsored by Medtronic. The authors have no competing interests declared.

Figures

Fig. 1
Fig. 1
A Phases of CO2 Waveform. Capnography waveform readings during a positive methacholine challenge test. B Normal waveform without airway obstruction. C Capnography waveform after FEV1 decrease
Fig. 2
Fig. 2
Data collection: For each segment of breath signals, the FEV1 at the end of the segment was considered as the gold standard reference value for obstruction level
Fig. 3
Fig. 3
Spirometry results for included patients with asthma and COPD
Fig. 4
Fig. 4
Model prediction results in two individual patients. blackmodel results per breath, Red star5min average of model resultsblue triangle dotspirometry value at the end of the segment
Fig. 5
Fig. 5
Correlation between FEV1 and Capnography Waveform Model
Fig. 6
Fig. 6
Error according to underlying disease
See this image and copyright information in PMC

References

    1. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease GOLD-2020- [cited 2020 Aug 28]. https://goldcopd.org/wp-content/uploads/2019/12/GOLD-2020-FINAL-ver1.2-0... - PubMed
    1. Global strategy for asthma management and preventionGINA-2020- [cited 2020 Aug 28]. https://ginasthma.org/wp-content/uploads/2020/04/GINA-2020-full-report_-...
    1. Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Eur Respir J. 2005;26(1):153–161. doi: 10.1183/09031936.05.00034505. - DOI - PubMed
    1. Culver BH, Graham BL, Coates AL, Wanger J, Berry CE, Clarke PK, et al. Recommendations for a standardized pulmonary function report. An Official American Thoracic Society Technical Statement. Am J Respir Crit Care Med. 2017;196(11):1463–1472. doi: 10.1164/rccm.201710-1981ST. - DOI - PubMed
    1. Guidelines for Methacholine and Exercise Challenge Testing1999: This official statement of the American Thoracic Society was adopted by the ATS board of directors, July 1999. Am J Respir Crit Care Med. 2000;161(1):30929. - PubMed

Publication types

MeSH terms

Associated data