Accuracy of volume measurements by a clinical spirometer in multiple veterinary hospitals

IntroductionSpirometry devices, which are components of many anaesthesia machines, are commonly used to assess lung mechanics during anaesthesia. Spirometry calibration usually adheres to manufacturer recommendations without established guidelines. Although more accurate and less variable than inbui...

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Main Authors: Mathieu Raillard, Martina Mosing, Anthea Raisis, Adam Auckburally, Karla Borland, Susana Canfrán, Frances Downing, Alejandra García de Carellán Mateo, Paul MacFarlane, William McFadzean, Tristan Merlin, Karine Portier, Josephine Robertson, Joao Henrique Neves Soares, Barbara Steblaj, Aurora Zoff, Olivier L. Levionnois
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Veterinary Science
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Online Access:https://www.frontiersin.org/articles/10.3389/fvets.2024.1475401/full
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author Mathieu Raillard
Martina Mosing
Martina Mosing
Anthea Raisis
Adam Auckburally
Karla Borland
Susana Canfrán
Frances Downing
Alejandra García de Carellán Mateo
Paul MacFarlane
William McFadzean
Tristan Merlin
Karine Portier
Karine Portier
Josephine Robertson
Joao Henrique Neves Soares
Barbara Steblaj
Aurora Zoff
Olivier L. Levionnois
author_facet Mathieu Raillard
Martina Mosing
Martina Mosing
Anthea Raisis
Adam Auckburally
Karla Borland
Susana Canfrán
Frances Downing
Alejandra García de Carellán Mateo
Paul MacFarlane
William McFadzean
Tristan Merlin
Karine Portier
Karine Portier
Josephine Robertson
Joao Henrique Neves Soares
Barbara Steblaj
Aurora Zoff
Olivier L. Levionnois
author_sort Mathieu Raillard
collection DOAJ
description IntroductionSpirometry devices, which are components of many anaesthesia machines, are commonly used to assess lung mechanics during anaesthesia. Spirometry calibration usually adheres to manufacturer recommendations without established guidelines. Although more accurate and less variable than inbuilt spirometry in certain General Electric anaesthesia ventilators, near-patient spirometry lacks adequate evaluation.MethodsWe assessed near-patient spirometers’ performance using Pedi-lite and D-lite flow sensors. Certified 1 L calibration syringes were used on 67 monitors located in 14 veterinary hospitals. Three consecutive inspired and expired volume values displayed by the monitors for each volume of the calibration syringe were recorded. Volumes studied were 50, 100, 150, 250, 300 mL for Pedi-lite and 150, 300, 450, 500, 750 mL for D-lite. Measured and targeted volumes were averaged, agreement error calculated. Accuracy was assessed plotting agreement errors against calibration volumes. A linear mixed-effects model was used to obtain linear regression between the error and the calibration volume. Mean, differential and proportional bias, limits of agreement, claimed accuracy and 10% clinical tolerance were calculated and displayed. Differences among monitors were evaluated using the Friedman rank sum test, differences between inspired and expired volumes using the Wilcoxon signed-rank.ResultsInter-monitor variability for inspired and expired volume readings using both sensors was high; intra-monitor variability was low. The error magnitude was independent of volumes evaluated. Using Pedi-lite, only a minority of measurements met manufacturer’s specification or a 10% clinical tolerance; both inspired and expired volumes were significantly underestimated. Using D-lite, superior performance was demonstrated for volumes between 300 and 750 mL (mean biases close to zero and the majority of measurements meeting manufacturer’s specifications and clinical tolerance). The difference between measured inspired and expired volumes with both sensors was significant.DiscussionThese results support caution when interpreting clinical measurements of lung volumes and mechanics in anaesthetised patients when using these sensors. This is particularly important in smaller patients where lung volumes are below 300 mL. Trends should be reliable.
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spelling doaj-art-a753ca747b6940bcaca0a1c88a0aec8b2024-12-04T09:51:40ZengFrontiers Media S.A.Frontiers in Veterinary Science2297-17692024-12-011110.3389/fvets.2024.14754011475401Accuracy of volume measurements by a clinical spirometer in multiple veterinary hospitalsMathieu Raillard0Martina Mosing1Martina Mosing2Anthea Raisis3Adam Auckburally4Karla Borland5Susana Canfrán6Frances Downing7Alejandra García de Carellán Mateo8Paul MacFarlane9William McFadzean10Tristan Merlin11Karine Portier12Karine Portier13Josephine Robertson14Joao Henrique Neves Soares15Barbara Steblaj16Aurora Zoff17Olivier L. Levionnois18School of Veterinary Medicine, College of Environmental and Life Sciences, Murdoch University, Murdoch, WA, AustraliaSchool of Veterinary Medicine, College of Environmental and Life Sciences, Murdoch University, Murdoch, WA, AustraliaClinical Department for Small Animals and Horses, Veterinary University Vienna, Vienna, AustriaSchool of Veterinary Medicine, College of Environmental and Life Sciences, Murdoch University, Murdoch, WA, AustraliaSouthern Counties Veterinary Specialists, Ringwood, United KingdomAnderson Moores, Hursley, United KingdomHospital Clínico Veterinario Complutense, Universidad Complutense de Madrid, Madrid, SpainDavies Veterinary Specialists, Herts, United KingdomHospital Veterinario de la Universidad Católica de Valencia “San Vicente Mártir”, Valencia, SpainLangford Vets, University of Bristol, Langford, United KingdomCave Veterinary Specialists, Wellington, United Kingdom0Eastcott Veterinary Clinic and Hospital, Swindon, United Kingdom1VetAgro Sup (Campus Vétérinaire), Centre de Recherche et de Formation en Algologie Comparée (CREFAC), University of Lyon, Marcy l’Etoile, France2Université Claude Bernard Lyon, Centre de Recherche en Neurosciences de Lyon, INSERM, CRNL, Trajectoire, Lyon, Bron, France3Small Animal Hospital, University of Glasgow, Glasgow, United Kingdom4Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States5Section Anaesthesiology, Department of Diagnostics and Clinical Sciences, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland6North Downs Specialist Referrals, Bletchingley, United Kingdom7Division of Anaesthesiology and Pain Therapy, Vetsuisse Faculty, University of Bern, Bern, SwitzerlandIntroductionSpirometry devices, which are components of many anaesthesia machines, are commonly used to assess lung mechanics during anaesthesia. Spirometry calibration usually adheres to manufacturer recommendations without established guidelines. Although more accurate and less variable than inbuilt spirometry in certain General Electric anaesthesia ventilators, near-patient spirometry lacks adequate evaluation.MethodsWe assessed near-patient spirometers’ performance using Pedi-lite and D-lite flow sensors. Certified 1 L calibration syringes were used on 67 monitors located in 14 veterinary hospitals. Three consecutive inspired and expired volume values displayed by the monitors for each volume of the calibration syringe were recorded. Volumes studied were 50, 100, 150, 250, 300 mL for Pedi-lite and 150, 300, 450, 500, 750 mL for D-lite. Measured and targeted volumes were averaged, agreement error calculated. Accuracy was assessed plotting agreement errors against calibration volumes. A linear mixed-effects model was used to obtain linear regression between the error and the calibration volume. Mean, differential and proportional bias, limits of agreement, claimed accuracy and 10% clinical tolerance were calculated and displayed. Differences among monitors were evaluated using the Friedman rank sum test, differences between inspired and expired volumes using the Wilcoxon signed-rank.ResultsInter-monitor variability for inspired and expired volume readings using both sensors was high; intra-monitor variability was low. The error magnitude was independent of volumes evaluated. Using Pedi-lite, only a minority of measurements met manufacturer’s specification or a 10% clinical tolerance; both inspired and expired volumes were significantly underestimated. Using D-lite, superior performance was demonstrated for volumes between 300 and 750 mL (mean biases close to zero and the majority of measurements meeting manufacturer’s specifications and clinical tolerance). The difference between measured inspired and expired volumes with both sensors was significant.DiscussionThese results support caution when interpreting clinical measurements of lung volumes and mechanics in anaesthetised patients when using these sensors. This is particularly important in smaller patients where lung volumes are below 300 mL. Trends should be reliable.https://www.frontiersin.org/articles/10.3389/fvets.2024.1475401/fullspirometryD-litePedi-litetidal volumecompliancerespiratory mechanics
spellingShingle Mathieu Raillard
Martina Mosing
Martina Mosing
Anthea Raisis
Adam Auckburally
Karla Borland
Susana Canfrán
Frances Downing
Alejandra García de Carellán Mateo
Paul MacFarlane
William McFadzean
Tristan Merlin
Karine Portier
Karine Portier
Josephine Robertson
Joao Henrique Neves Soares
Barbara Steblaj
Aurora Zoff
Olivier L. Levionnois
Accuracy of volume measurements by a clinical spirometer in multiple veterinary hospitals
Frontiers in Veterinary Science
spirometry
D-lite
Pedi-lite
tidal volume
compliance
respiratory mechanics
title Accuracy of volume measurements by a clinical spirometer in multiple veterinary hospitals
title_full Accuracy of volume measurements by a clinical spirometer in multiple veterinary hospitals
title_fullStr Accuracy of volume measurements by a clinical spirometer in multiple veterinary hospitals
title_full_unstemmed Accuracy of volume measurements by a clinical spirometer in multiple veterinary hospitals
title_short Accuracy of volume measurements by a clinical spirometer in multiple veterinary hospitals
title_sort accuracy of volume measurements by a clinical spirometer in multiple veterinary hospitals
topic spirometry
D-lite
Pedi-lite
tidal volume
compliance
respiratory mechanics
url https://www.frontiersin.org/articles/10.3389/fvets.2024.1475401/full
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