{"id":83444,"date":"2021-04-15T10:18:55","date_gmt":"2021-04-15T08:18:55","guid":{"rendered":"https:\/\/ibecbarcelona.eu\/?p=83444"},"modified":"2021-04-15T10:27:57","modified_gmt":"2021-04-15T08:27:57","slug":"investigadors-de-libec-desenvolupen-un-metode-no-invasiu-per-avaluar-malalties-pulmonars","status":"publish","type":"post","link":"https:\/\/ibecbarcelona.eu\/ca\/investigadors-de-libec-desenvolupen-un-metode-no-invasiu-per-avaluar-malalties-pulmonars\/","title":{"rendered":"Investigadors de l\u2019IBEC desenvolupen un m\u00e8tode no invasiu per avaluar malalties pulmonars"},"content":{"rendered":"

\"\"<\/p>\n

Aquest nou enfocament s\u2019ha provat en pacients i combina la bioimped\u00e0ncia tor\u00e0cica i els senyals musculars respiratoris el\u00e8ctrics i mec\u00e0nics que permeten mesurar el nivell de funci\u00f3 pulmonar d\u2019una manera no invasiva i quantitativa, reduint els inconvenients per als pacients.
\nLa malaltia pulmonar obstructiva cr\u00f2nica (MPOC) \u00e9s una malaltia freq\u00fcent caracteritzada per problemes respiratoris i poc flux d\u2019aire que es produeix en adults. \u00c9s la cinquena principal causa de mort a tot el m\u00f3n i una de les principals causes de morbiditat <\/span>cr\u00f2nica <\/span>i mortalitat. Actualment, per avaluar la funci\u00f3 pulmonar, els pacients <\/span>se sotmeten a proves que es basen en maniobres <\/span>f\u00edsiques<\/span> i a un augment de l’esfor\u00e7 inspiratori general necessari per respirar per quantificar el nivell de limitaci\u00f3 del flux d’aire. A m\u00e9s, per avaluar completament el pacient, el resultat de les proves s\u2019ha de completar amb informaci\u00f3 dels q\u00fcestionaris, que inclou<\/span>en<\/span> un cert grau de subjectivitat i dades no quantificables que dificulten una avaluaci\u00f3 objectiva.<\/span>\u00a0<\/span><\/p>\n

Ara, un equip d\u2019investigadors dirigit per Raimon Jan\u00e9, l\u00edder del grup de <\/span>Processat i Interpretaci\u00f3 de Senyals Biom\u00e8dic<\/span><\/a> (BIOSPIN) de l\u2019IBEC i professor de la UPC, en col\u00b7laboraci\u00f3 amb investigadors <\/span>de <\/span>l\u2019<\/span>imec<\/span> dels Pa\u00efsos Baixos i B\u00e8lgica (prof. <\/span>Francky<\/span> Catthoor<\/span>), i <\/span>d<\/span>el <\/span>Ziekenhuis<\/span> Oost<\/span> –<\/span> Limburg<\/span> Hospital a B\u00e8lgica, publica a la revista <\/span>IEEE <\/span><\/i>Transactions<\/span><\/i> on <\/span><\/i>Biomedical<\/span><\/i> Engineering<\/span><\/i> Journal<\/span><\/i><\/a>, un nou enfocament per avaluar la MPOC. La nova metodologia, no invasiva i quantificable, es va aplicar als pacients amb MPOC i es basa en la combinaci\u00f3 de senyals <\/span>bioimpedancials<\/span> i miogr\u00e0fics per mesurar la contribuci\u00f3 de l\u2019activitat muscular inspirat\u00f2ria a la ventilaci\u00f3 pulmonar. Aquesta proposta \u00e9s un dels resultats rellevants del projecte conjunt \u201cAvaluaci\u00f3 d\u2019\u00edndexs no invasius per al seguiment respiratori, centrat en l\u2019aplicabilitat a casa\u201d per part de l\u2019IBEC i <\/span>l\u2019<\/span>imec<\/span>, i del projecte \u201cEcosistema de salut intel\u00b7ligent (eines, aplicacions i dispositius) per a la medicina personalitzada i l\u2019atenci\u00f3 sanit\u00e0ria en malalties respirat\u00f2ries i trastorns del son \u201d(<\/span>SappHiRES<\/span>), dirigit pel prof. Jan\u00e9.<\/span>\u00a0<\/span><\/p>\n

Un m\u00e8tode m\u00e9s c\u00f2mode i no invasiu per controlar les malalties pulmonars\u00a0<\/strong><\/h2>\n

La disfunci\u00f3 muscular respirat\u00f2ria es produeix molt sovint en pacients amb MPOC i contribueix a la sensaci\u00f3 d<\/span>e falta d\u2019a<\/span>ire<\/span>. Aquesta disfunci\u00f3 es mesura per l’activitat muscular inspirat\u00f2ria i la producci\u00f3 respirat\u00f2ria global, i es comparen les dades amb persones sanes per avaluar l’efic\u00e0cia dels m\u00fasculs respiratoris en la ventilaci\u00f3. Un exemple d\u2019un procediment actual per avaluar la disfunci\u00f3 del<\/span>s<\/span> m\u00fascul<\/span>s<\/span> respiratori<\/span>s<\/span> \u00e9s una mesura invasiva de l\u2019esfor\u00e7 respiratori neural de la part crural del diafragma mitjan\u00e7ant un cat\u00e8ter, que resulta inc\u00f2mode per al pacient, requereix una assist\u00e8ncia cl\u00ednica <\/span>especialitzada<\/span> i representa un desavantatge per a<\/span>l<\/span> seguiment<\/span> sistem\u00e0tic<\/span> de la malaltia.<\/span>\u00a0<\/span><\/p>\n

Alguns procediments no invasius per avaluar la disfunci\u00f3 pulmonar inclouen la mesura de senyals fisiol\u00f2gics mitjan\u00e7ant sensors superficials connectats a la pell del pacient, com ara la <\/span>bioimped\u00e0ncia<\/span> i els senyals miogr\u00e0fics. D’una banda, la <\/span>bioimped\u00e0ncia<\/span> mesura la capacitat d’un teixit biol\u00f2gic per impedir el corrent el\u00e8ctric. D\u2019altra banda, els senyals <\/span>electromiogr\u00e0fics<\/span> (EMG) i <\/span>mecanomiogr\u00e0fics<\/span> (MMG) mesuren l\u2019activitat el\u00e8ctrica i mec\u00e0nica dels m\u00fasculs respectivament, en el cas d\u2019aquest estudi, la paret inferior del <\/span>t\u00f2rax<\/span>. S\u2019ha demostrat que aquestes tres mesures no invasives s\u00f3n capaces d\u2019avaluar la respiraci\u00f3 de forma independent, per\u00f2 mai s\u2019ha<\/span>vien<\/span> combinat per donar una imatge m\u00e9s \u00e0mplia de les disfuncions pulmonars.<\/span>\u00a0<\/span><\/p>\n

La novetat del enfocament presentat en aquest treball es basa en les mesures simult\u00e0nies i no invasives de la bioimped\u00e0ncia i els senyals musculars el\u00e8ctrics i mec\u00e0nics dels espais intercostals inferiors, per investigar les respostes ventilat\u00f2ries durant la respiraci\u00f3 dels pacients amb MPOC<\/strong><\/p>\n

Dolores Blanco-Almaz\u00e1n, primera autora de l’obra.\u00a0<\/strong><\/p>\n<\/blockquote>\n

\u00a0<\/span><\/p>\n

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En aquest estudi, es van adquirir senyals de <\/span>bioimped\u00e0ncia<\/span>, EMG i MMG mitjan\u00e7ant un dispositiu de recerca <\/span>port\u00e0til<\/span> i un sistema d\u2019adquisici\u00f3 est\u00e0ndard per cable. Tant els senyals de <\/span>bioimped\u00e0ncia<\/span> com els EMG van ser capt<\/span>ats<\/span> per el\u00e8ctrodes superficials, mentre que els senyals MMG es van registrar mitjan\u00e7ant un acceler\u00f2metre, tots fixats adhesivament a la regi\u00f3 tor\u00e0cica dels pacients que van romandre c\u00f2modament asseguts en <\/span>posici\u00f3 dreta<\/span> durant tot el procediment. La nova versi\u00f3 del sistema d\u2019adquisici\u00f3 utilitzat, un sistema en xip (<\/span>SoC<\/span>), permet enregistrar simult\u00e0niament <\/span>bioimped\u00e0ncia<\/span>, EMG i MMG aplicant un enfocament multimodal per reduir la <\/span>intrusivitat<\/span>, la qual cosa refor\u00e7a l<\/span>a idea d\u2019una monitoritzaci\u00f3 de la respiraci\u00f3 c\u00f2moda per al pacient <\/span>i el seu potencial \u00fas ambulatori o dom\u00e8stic.<\/span>\u00a0<\/span><\/p>\n

 <\/p>\n

<\/h6>\n
<\/h6>\n
<\/h6>\n
\n
\n
Imatge: representaci\u00f3 de la ubicaci\u00f3 dels el\u00e8ctrodes (<\/span>adhesius<\/span> bla<\/span>us<\/span> i blan<\/span>cs<\/span>) i acceler\u00f2metre (petit quadrat negre).<\/span>\u00a0<\/span><\/h6>\n

 <\/p>\n

Nous \u00edndexs per quantificar la disfunci\u00f3 muscular respirat\u00f2ria\u00a0<\/strong><\/h2>\n

Els investigadors proposen dos nous \u00edndexs per quantificar la disfunci\u00f3 del<\/span>s<\/span> m\u00fascul<\/span>s<\/span> respiratori<\/span>s<\/span> en pacients amb MPOC: <\/span>els coeficients<\/span> BEr<\/span> i <\/span>BMr<\/span>. Avaluen la variaci\u00f3 de la <\/span>bioimped\u00e0ncia<\/span> i l\u2019activitat el\u00e8ctrica i mec\u00e0nica durant cada cicle respiratori i quantifiquen la contribuci\u00f3 de l\u2019activaci\u00f3 del<\/span>s<\/span> m\u00fascul<\/span>s<\/span> inspira<\/span>toris<\/span> de la paret<\/span> tor\u00e0cica<\/span> inferior a la ventilaci\u00f3, \u00e9s a dir, la relaci\u00f3 <\/span>entre<\/span> la <\/span>bioimped\u00e0ncia<\/span> i<\/span> l\u2019<\/span>EMG (<\/span>BEr<\/span>) i <\/span>el <\/span>MMG (<\/span>BMr<\/span>).<\/span>\u00a0<\/span><\/p>\n

Aquests nous \u00edndexs consideren diferents par\u00e0metres relacionats amb el patr\u00f3 respiratori i van mostrar difer\u00e8ncies significatives entre els pacients amb MPOC lleu i greu, <\/span>on els <\/span>pacients lleus presenten una contribuci\u00f3 inspirat\u00f2ria m\u00e9s elevada dels m\u00fasculs inspiratoris a la ventilaci\u00f3 respirat\u00f2ria global que els greus, \u00e9s a dir, els pacients amb MPOC greus necessiten significativament m\u00e9s nivells d’activitat el\u00e8ctrica i mec\u00e0nica dels m\u00fasculs per respirar. Per tant<\/span>, <\/span><\/b>tant els senyals de bioimped\u00e0ncia com els senyals miogr\u00e0fics s\u00f3n alternatives potencials als m\u00e8todes invasius i intrusius tradicionals en la caracteritzaci\u00f3 de malalties respirat\u00f2ries.\u00a0<\/strong><\/p>\n

Aquest treball avalua la contribuci\u00f3 de l’activitat muscular a la ventilaci\u00f3 respirat\u00f2ria global mitjan\u00e7ant l’\u00fas de dos nous \u00edndexs i valida l’\u00fas combinat de bioimped\u00e0ncia i senyals miogr\u00e0fics per proporcionar par\u00e0metres \u00fatils per avaluar de forma no invasiva la MPOC.<\/strong><\/p>\n

Raimon Jan\u00e9\u00a0<\/strong><\/p>\n<\/blockquote>\n

El nou procediment proposat en aquest estudi obre les portes a refor\u00e7ar la combinaci\u00f3 de <\/span>bioimped\u00e0ncia<\/span> i senyals miogr\u00e0fics per controlar les malalties respirat\u00f2ries d\u2019una manera no invasiva i totalment quantificable, ajudant a avaluar la millora o el deteriorament de la disfunci\u00f3 pulmonar en pacients amb MPOC.<\/span>\u00a0<\/span><\/p>\n

\n
\n

Article de refer\u00e8ncia:<\/strong> Dolores Blanco-<\/span>Almaz\u00e1n<\/span>, <\/span>Willemijn<\/span> Groenendaal<\/span>, Manuel Lozano-Garc\u00eda, Luis Estrada-<\/span>Petrocelli<\/span>, <\/span>Lien<\/span> Lijnen<\/span>, <\/span>Christophe<\/span> Smeets<\/span>, David <\/span>Ruttens<\/span>, <\/span>Francky<\/span> Catthoor<\/span> and<\/span> Raimon Jan\u00e9. <\/span>Combining<\/span> Bioimpedance<\/span> and<\/span> Myographic<\/span> Signals<\/span> for <\/span>the<\/span> Assessment<\/span> of COPD <\/span>during<\/span> Loaded<\/span> Breathing<\/span>.<\/span><\/a> IEEE <\/span><\/i>Transactions<\/span><\/i> on <\/span><\/i>Biomedical<\/span><\/i> Engineering<\/span><\/i> (2021)<\/span><\/i>, 68 (1), 298-307.<\/span>\u202f<\/span><\/p>\n

Blanco-<\/span><\/i>Almaz\u00e1n<\/span><\/i>, M. Lozano-Garc\u00eda, L. Estrada-<\/span><\/i>Petrocelli<\/span><\/i> i<\/span><\/i> R. Jan\u00e9 <\/span><\/i>son membres del <\/span><\/i>BIOSPIN (IBEC) <\/span><\/i>i del<\/span><\/i> B<\/span><\/i>iomedical<\/span><\/i> Research<\/span><\/i> Networking<\/span><\/i> Center<\/span><\/i> in <\/span><\/i>Bioengineering<\/span><\/i>, Biomaterials <\/span><\/i>and<\/span><\/i> Nanomedicine<\/span><\/i> (CIBER- BBN).<\/span><\/i>\u202f<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Un equip d\u2019investigadors dirigit per Raimon Jan\u00e9 de l\u2019IBEC, juntament amb col\u00b7laboradors internacionals de l\u2019imec als Pa\u00efsos Baixos i un hospital a B\u00e8lgica, desenvolupa un procediment innovador per avaluar les malalties pulmonars. <\/h3>\n","protected":false},"author":4,"featured_media":83451,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[96],"tags":[1468,1116],"post_formats":[],"class_list":["post-83444","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-noticies-de-recerca","tag-malaltia-pulmonar","tag-raimon-jane-ca"],"yoast_head":"\nInvestigadors de l\u2019IBEC desenvolupen un m\u00e8tode no invasiu per avaluar malalties pulmonars - Institute for Bioengineering of Catalonia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link 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