Breathing Patterns in Acute Illness

Background: Clinical observations of breathing are rudimentary, compared with, for example, the use of ultrasound to display circulatory pathophysiology. However measurements of respiratory flow can be easily made with nasal cannula pressure, and could be displayed on a monitor screen or smartphone. Respiratory flow measurements were recorded in patients admitted to hospital with acute illness, and often showed abnormalities which might prove useful in diagnosis or prognosis. Methods: A cohort of patients had been recruited to allow assessment of a new device intended for continuous measurement of respiratory rate. The comparison was with a signal from a nasal cannula, which is minimally invasive, and gives a signal analogous to flow. Nasal flow recordings were obtained from 63 patients (35 were female), age 61 (17) (Mean, SD). On inspection, this set of records showed features of interest, so a subsequent formal analysis of abnormal patterns was done, and is reported. Results: The median respiratory rate the patients was 25 (22, 29) (median, quartiles) breath.min-1. Abnormal breathing patterns were very frequent. These included early inspiration in 82%, and also expiratory flow limitation, passive expiration, and delayed or absent active inspiration (63%). Cyclical variation in breath size was noted in 8% of the patients, indicating a minor degree of Cheynes-Stokes pattern breathing. Conclusions: In acutely ill medical patients, unexpected abnormal breathing is frequent. This can be detected by nasal pressure measurement. Some abnormalities could be useful for diagnosis and prognosis, such as incipient ventilatory failure: formal prospective study could be valuable. Received: May 20, 2019; Accepted: June 25, 2019; Published: June 27, 2019 European Journal of Respiratory Medicine 2019; 1(1): 111 115. doi: 10.31488/ejrm.103 Eur J Respir Med,1:1 European Journal of Respiratory Medicine Gordon B Drummond* Department of Anaesthesia and Pain Medicine, University of Edinburgh, UK Breathing Patterns in Acute Illness