Analysis of multiple linear regression algorithms used for respiratory mechanics monitoring during artificial ventilation

Many patients undergo long-term artificial ventilation and their respiratory system mechanics should be monitored to detect changes in the patient's state and to optimize ventilator settings. In this work the most popular algorithms for tracking variations of respiratory resistance (Rrs) and elastance (Ers) over a ventilatory cycle were analysed in terms of systematic and random errors. Additionally, a new approach was proposed and compared to the previous ones. It takes into account an exact description of flow integration by volume-dependent lung compliance. The results of analyses showed advantages of this new approach and enabled to form several suggestions. Algorithms including Rrs and Ers dependencies on airflow and lung volume can be effectively applied only at low levels of noise present in measurement data, otherwise the use of the simplest model with constant parameters is preferable. Additionally, one should avoid including the resistance dependence on airflow alone, since this considerably destroys the retrieved trace of Rrs. Finally, the estimated cyclic trajectories of Rrs and Ers are more sensitive to noise present in pressure than in the flow signal, and the elastance traces are estimated more accurately than the resistance ones.