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EtCO2 -Based Biofeedback Method of Breath Regulation Increases Speech Fluency of Stuttering People

Stankiewicz B., Zieliński K., Darowski M., Michnikowski M.

Archives of Acoustics

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2015

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Vol. 40, No. 4

469–-474

EN

Respiratory disturbances frequently accompany stuttering. Their influence on lung ventilation can be assessed by measurement of the end-tidal CO2 concentration (EtCO2). The effectiveness of the CO2-based visual feedback method of breath regulation (VF) designed for stuttering therapy was tested in this study. The aim of the study was to answer the question if the VF helps to reduce respiratory disturbances in stuttering and increase speech fluency. 20 stuttering volunteers aged 13–45 years took part in the 3-parts test consisting of: 1. speaking without any techniques improving speech fluency, 2. learning the VF method, 3. VF-assisted speaking. The CO2/time signal and an acoustic signal of an utterance were recorded during the test. Significant increase of FE – the factor of breath ergonomics during speaking (based on both signals), from 47% to 71% (P < 0.01), and significant decrease of %SS – the percent of syllables stuttered, from 14% to 10% (P < 0.01) were received for VF-assisted utterances compared to the utterances without VF assistance. The results indicate that the VF can help to eliminate respiratory disturbances in stuttering and increase speech fluency.

2

A new control solution for independent synchronous ventilation of lungs

Darowski M., Michnikowski M., Nestorowicz A., Mikaszewska-Sokolewicz M., Glapiński J., Guć M., Stankiewicz B.

Biocybernetics and Biomedical Engineering

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2010

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Vol. 30, no. 2

29-39

EN

A new control solution for independent, synchronous ventilation of lungs has been developed and a controller to perform it with use of only one respirator and a bilumen intubation tube has been built. The controller enables division of the inspiratory tidal volume between the lungs in desired ratio, and setting of the positive end-expiratory pressure (PEEP) separately for each lung. The model tests have shown that the characteristics of the flow meters used, however not linear, is good enough to achieve clinically accepted accuracy of volume division. The tests have shown that the volume division is independent from the total tidal volume and PEEP. Maximal errors of the tidal volume division was less than 10%. The case study of patient after lung injury has shown significant improvement of the X-ray image and respiratory parameters (blood oxygenation, ventilatory pressures) during the independent ventilation of lungs with the use of the new device. The clinical study of 60 patients has shown that differences between actually realized volume division and the adjusted values are practically negligible.

3

A hybrid model of the respiratory system

Michnikowski M., Glapiński J., Guć M., Gólczewski T., Darowski M.

Biocybernetics and Biomedical Engineering

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2009

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Vol. 29, no. 1

71-80

EN

The aim of this work is building a hybrid model of the human respiratory system which enables connecting the real clinical devices (respirators) with the computerized virtual lungs. A simulation of the artificial ventilation of lungs, with the use of the hybrid model and the Siemens Servo 900 respirator, was made. Waveforms of pressure inside the lungs, flow in the respiratory tract, and the lung volume during the simulated artificial ventilation were recorded. The compliance and resistance of the hybrid model of the respiratory system were calculated on the basis of the inspiratory pause algorithms and compared to the values set in the model. The initial tests have shown that the calculated values of the parameters differ by 20% (worst result) from the values set in the model. The model will enable the investigation of the different modes of lung ventilation, as well as educational presentation of the respirator-patient interaction.

4

Choice of proper lung ventilation method

Darowski M., Gólczewski T., Michnikowski M.

Biocybernetics and Biomedical Engineering

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2006

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Vol. 26, no. 1

21-37

EN

In the article three different methods of lung ventilation have been analyzed: Continuous Positive Airways Pressure (CPAP), Proportional Assist Ventilation (PAV) and Pressure Support Ventilation (PSV). The aim of these analyses was to predict clinical situations when the considered modes of ventilation would play their role in the best, optimal way. The study on effective ventilatory support by CPAP, PAV and PSY was conducted using virtual respiratory system - a new, but yet verified model of the system, recently developed by our group. Computer simulation, done on a healthy lung model and on a pathologically changed lung model, has clearly shown the conditions under which CPAP, PAV or PSY could be really effective. CPAP is worth using in patients with a high airways resistance, in which case this mode of ventilatory support ensures breathing with normal frequency and less energy-consuming inspiration. PAV usually results in a smaller peak and the mean alveolar pressure than PSY which decreases a potentially harmful effect of the positive pressure ventilation on the cardiovascular system. On the other hand, PAV may be used safely when estimation of the parameters such as the lung/thorax compliance and the airway resistance is reliable, since the setting of the supporting pressure is based on this estimation.