The recent developments in image processing and parallel computing make the analysis of the movements of any number of points on the chest wall both possible and practical. It is therefore now possible to obtain a quantitative and detailed image of the complex movements involved in respiration. This allows either a better understanding of respiration physiology and pathologicalbehaviours or new perspectives for diagnosis, prognosis and therapeutic treatments. The image processing procedures implemented by a parallel architecture provide the necessary accuracy. The proposed method allows the three-dimensional (3-D) analysis of the displacements of any number of points on the chest wall and abdomen. Thus, through a specially designed model, the trunk volume variations during respiration and various manoeuvres (tidal volume, deep breathing, vital capacity, etc.) and its splitting into different compartments of physiopathological interest like horizontal sections (upper thorax, lower thorax and abdomen) and vertical ones (right and left) can be estimated. This approach is completely non-invasive and non-ionising; the 3-D movements of several body landmarks of the thorax, abdomen and back, are tracked by an automatic image processor connected to a computer. The subject is completely free to move and the analysis can be performed in different postures (upright, sitting and supine) and for long periods of time. Since the proposed method provides a direct measurement of the volumes in a three-dimensional reference frame, it can be used without a subject specific calibration. The technical validation of the method 'per se' has been already fully performed and the feasibility of this project has been proved by the results already obtained [Ferrigno et al., 1994]. Starting from the preliminary results already obtained, the goal of this project is the development, the technical validation and the application to physiology and clinics of an innovative method for the evaluation of respiratory mechanics. The main objective of this study is a collaborative effort of internationally recognized centres in Europe and extra european countries (Canada, Australia andSlovenia) involved in biomedical engineering, respiratory physiology and clinics, in order to develop a strongly innovative and non invasive system for the analysis of respiratory function able to provide new and unique data for improving basic knowledge in physiology and clinical practice. The objectives can be grouped as: - Development and optimization of basic technologies and methodologies until no developed only in a research environment, software development clinically ori creation of reference databases and modelling.
These objectives will be persec by the group of Prof. Pedotti in collaboration with Prof. Baconnier's group. - Application in physiology of this new technique, in order to provide selected reference physiological models to clinics. (Prof. Macklem in collaboration wi Prof. Pedotti and Dr. Cala's groups). - Correlation between external images of chest wall motion with internal images of the diaphragm and the lung.(Prof. Macklem and Prof. Pedroso de Lima in collaboration with Prof. Pedotti's and Dr. Cala's groups). - Clinical evaluation, through experimental sessions. These objectives will be persecuted by the group of Prof.Yernault. - Testing and optimisation of therapeutical intervention, in particular mechani ventilation (Prof. Gattinoni's group), functional electrical stimulation of respiratory muscles: diaphragm pacing (Dr. Exner and Prof.Krishnan's groups) abdominal muscles (Prof. Stanic's group); respiratory muscular training (Prof. Calverly's group).
The proposal is an important contribution to 1) the coordination of basic and applied research in respiratory devices, instruments and techniques 2) the development and improvement of diagnostic and therapeutic tools methods and standards, 3) the improvement of their quality and the recovery of respiratory function, 4) the reduction of cost/benefit ratio in health care, 5) the improvement of competitiveness of European industries. The main goal of the proposal is exactly matching with the priorities of Biomed2 workprogramme: - to transfer research results in biomedical engineering into clinical practic- making clinicians aware of the possibilities offered by engineering, new technologies, methods and devices and matching the research and development the needs offered by clinicians - clinical assessment through clinical trials - development of new European biomedical equipment.
Funding SchemeCSC - Cost-sharing contracts