Evaluation of model-based methods in estimating respiratory mechanics in the presence of variable patient effort.

Monitoring of respiratory mechanics is required for guiding patient-specific mechanical ventilation settings in critical care. Many models of respiratory mechanics perform poorly in the presence of variable patient effort. Typical modelling approaches either attempt to mitigate the effect of the patient effort on the airway pressure waveforms, or attempt to capture the size and shape of the patient effort.

A polynomial model of patient-specific breathing effort during controlled mechanical ventilation.

Patient breathing efforts occurring during controlled ventilation causes perturbations in pressure data, which cause erroneous parameter estimation in conventional models of respiratory mechanics. A polynomial model of patient effort can be used to capture breath-specific effort and underlying lung condition. An iterative multiple linear regression is used to identify the model in clinical volume controlled data.

Lung injury and respiratory mechanics in rugby union.

Background: Rugby is a highly popular team contact sport associated with high injury rates. Specifically, there is a chance of inducing internal lung injuries as a result of the physical nature of the game. Such injuries are only identified with the use of specific invasive protocols or equipment.

The Walter Reed palm-held psychomotor vigilance test.

This field-portable reaction time test and analysis software run on devices using the Palm operating system. It is designed to emulate a test and commercial device widely used in sleep deprivation, shift work, fatigue, and stimulant drug research but provides additional capabilities. Experimental comparisons with the standard commercial device in a 40-hour total sleep deprivation study show it to be comparably sensitive to selected experimental variables.

High-frequency EEG as measure of cognitive function capacity: a preliminary report.

Background: High-frequency EEG (HFE) as a potential predictor of alertness/drowsiness was first proposed by Kaplan and Loparo. Sampling EEG at 950 Hz, they established an HFE bandwidth of interest ranging from 100-475 Hz. We extend their work by applying discrete Fourier transform (DFT) of HFE signals sampled at 1000 Hz and partitioned into spectral bands along specific frequency ranges for the assessment of sleep-wake state transition, sleep, and active cognitive engagement.

Oculomotor responses during partial and total sleep deprivation.

Introduction: Oculomotor responses related to the pupil light reflex (PLR) and saccadic velocity may be sensitive to the effects of sleepiness and therefore could be used to evaluate an individual's fitness for duty.

Methods: There were 12 normal subjects who completed an 8-d study. They were allowed 8 h in bed on the first three nights, 4 h in bed on the fourth night, and then were sleep deprived for the following 64 h.

Visual perception, psychomotor performance, and complex motor performance during an overnight air refueling simulated flight.

Introduction: Visual perception task, complex motor flight task, and psychomotor vigilance task performances were evaluated in U.S. Air Force pilots navigating a high-fidelity fixed wing jet simulator over 26.

Comparative utility of instruments for monitoring sleepiness-related performance decrements in the operational environment.

As both military and commercial operations increasingly become continuous, 24-h-per-day enterprises, the likelihood of operator errors or inefficiencies caused by sleep loss and/or circadian desynchrony also increases. Avoidance of such incidents requires the timely application of appropriate interventions--which, in turn, depend on the ability to measure and monitor the performance capacity of individuals in the operational environment. Several factors determine the potential suitability of candidate measures, including their relative sensitivity, reliability, content validity, intrusiveness and cumbersomeness/fieldability.

Modulating the homeostatic process to predict performance during chronic sleep restriction.

Background: In most current sleep/performance models, the homeostatic process is generally conceived as a simple reservoir in which performance capacity increases exponentially during sleep and decays either linearly or exponentially during wakefulness. Models that include this notional homeostatic process have been successful for describing sleep-performance data under conditions of irregular sleep schedules, jet lag, and short periods of total sleep loss. However, recently described data from sleep restriction studies indicate that recovery following chronically restricted sleep is considerably slower than would be predicted by these models.

Fatigue models for applied research in warfighting.

The U.S. Department of Defense (DOD) has long pursued applied research concerning fatigue in sustained and continuous military operations.

Patterns of performance degradation and restoration during sleep restriction and subsequent recovery: a sleep dose-response study.

Daytime performance changes were examined during chronic sleep restriction or augmentation and following subsequent recovery sleep. Sixty-six normal volunteers spent either 3 (n = 18), 5 (n= 16), 7 (n = 16), or 9 h (n = 16) daily time in bed (TIB) for 7 days (restriction/augmentation) followed by 3 days with 8 h daily TIB (recovery). In the 3-h group, speed (mean and fastest 10% of responses) on the psychomotor vigilance task (PVT) declined, and PVT lapses (reaction times greater than 500 ms) increased steadily across the 7 days of sleep restriction.