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Images from Shutterstock.com Medical conditions that CRG is needed: THE CRG What is cardiorespirograph? Cardiorespirograph Cardiorespirography is defined as the simultaneous recording of cardiac and respiratory action by means of a slow recorder. The cardiogram is obtained by beat to beat analysis, a proven technique of evaluating fetal heart rate changes for cardiotocography since the early 1960's. Definition of terms: Apnea (or sleep apnea in British English; /æpni/) is a sleep disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing during sleep.
Bradycardia -in an adult is any heart rate less than 60 beats per minute (bpm), although symptoms usually manifest only for heart rates less than 50
Cardiotocography (CTG) - is a technical means of recording (-graphy) the fetal heartbeat (cardio-) and the uterine contractions (-toco-) during pregnancy, typically in the third trimester. The machine used to perform the monitoring is called a cardiotocograph, more commonly known as an electronic fetal monitor (EFM).
Tachycardia - is a heart rate that exceeds the normal range. A heart rate over 100 beats per minute is generally accepted as tachycardia
Cardiorespirograph: A.oscilloscope; B respiratory
monitor module (impedance method); 4 cardiac
monitor module with digital indication of averaged
heart rate; 4 recorder for cardiac activity (5, beat to
beat tracing) and respirogram (6); 7 alarms (continuous recording or recording for two minutes with alarm events).
Block diagram of CRG: Cardiorespirography recorder and printout for an apneic attack (alarm printout). Numbers and letters in the original printout have been enhanced for better reproduction; 1) Apneic attacks - The length of apnea after which an alarm and a printout is to occur is variable (10, 20 or 30 seconds). After the selected time has elapsed without respiratory activity an alarm printout will occur marked as apnea (APN; Fig. 2). Simultaneously the following information is indicated: the parameters of heart rate variability from the last "routine" printout (see part II), the instantaneous heart rate and the respiratory rate. The respiratory rate is calculated from the formula (a) AF = Rx - (Κχ - R2)/8. In this formula AF is the respiratory rate on the printout, R2 is the reciprocal value of the time interval between the two preceeding respiratory trigger impulses multiplied by 60, and R χ is the similarly obtained AF value. This formula results in a moderate smoothing of the values. Tachycardia — (Heart rate> 180/min; code TACHY). A tachycardia results in a printout after at least a 20 tachycardia beats. Within the 20 beats a maximum of 10 beats deviating into the normal range are permitted Bradycardia — (Heart rate < 80/min; printout code: BRADY). A printout for bradycardia occurs: a) as "V" — bradycardia (Fig. 3) following minimally two, maximally five brady cardie beats. Behind the code for bradycardia a "— V" is printed out and thus indicates that it is a V shaped decrease and increase of the heart rate. Instead of the otherwise customary indication of actual heart rate the lowest heart rate during
the V bradycardia is documented. b) as "U"-brady cardia after at least 10 brady cardie beats (Fig. 4). The U shaped course of bradycardia is marked by "— U" and the lowest heart rate is indicated. The bradycardia printout occurs only after at least 20 normal beats have been counted following the brady cardie event
c) if simultaneously with the bradycardia an apnea occurs before the end of the bradycardic event the code "APN + BRADY" causes an alarm printout (Fig. 5). The correlation between V or U bradycardia respectively is then obtained in a second printout following normalization of the heart rate. Types of bradycardia: Summary:
Cardiorespirography is a well-known method of continuous
monitoring in neonatal intensive care. Apneic
attacks, bradycardia and tachycardia are registered. In our
experience we connected a cardiorespirography recorder
to a microprocessor system. The processor consisted of a
hardware part including a program (software) and a
printer which provided printouts of alarm events.
As alarm situations, which cause an alarm printout, we
1. apneic episodes (duration 10, 20 or 30 seconds)
2. tachycardiac (beat-to-beat rate > 180/minute)
3. V-shaped and U-shaped bradycardia (beat-to-beat
heart rate < 80/min) and combinations.
The reliability of the system of recognizing and classifying
alarm situations was tested by comparing the alarm
printouts with the simultaneously recorded cardiorespirograms.