Detection of intratracheal accumulation of thick secretions by using continuous monitoring of respiratory acoustic spectrum: a preliminary analysis

Moon, Young‐Jin; Bechtel, Allison J.; Kim, Sung Hoon; Kim, Jae-Won; Thiele, Robert H.; Blank, Randal S.

doi:10.1007/s10877-019-00359-z

Cited by 8 publications

(9 citation statements)

References 20 publications

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“…While band pass filters and spectral analysis have previously been applied to process heart and lung sounds, our methodology is the first designed to quantitate and characterize pulmonary air leak sounds. 23 , 24 , 25 , 26 , 27 …”

Section: Discussionmentioning

confidence: 99%

Sound‐guided assessment and localization of pulmonary air leak

Pinezich

Mir

Reimer

et al. 2022

Bioengineering & Transla Med

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Pulmonary air leak is the most common complication of lung surgery, with air leaks that persist longer than 5 days representing a major source of post‐surgery morbidity. Clinical management of air leaks is challenging due to limited methods to precisely locate and assess leaks. Here, we present a sound‐guided methodology that enables rapid quantitative assessment and precise localization of air leaks by analyzing the distinct sounds generated as the air escapes through defective lung tissue. Air leaks often present after lung surgery due to loss of tissue integrity at or near a staple line. Accordingly, we investigated air leak sounds from a focal pleural defect in a rat model and from a staple line failure in a clinically relevant swine model to demonstrate the high sensitivity and translational potential of this approach. In rat and swine models of free‐flowing air leak under positive pressure ventilation with intrapleural microphone 1 cm from the lung surface, we identified that: (a) pulmonary air leaks generate sounds that contain distinct harmonic series, (b) acoustic characteristics of air leak sounds can be used to classify leak severity, and (c) precise location of the air leak can be determined with high resolution (within 1 cm) by mapping the sound loudness level across the lung surface. Our findings suggest that sound‐guided assessment and localization of pulmonary air leaks could serve as a diagnostic tool to inform air leak detection and treatment strategies during video‐assisted thoracoscopic surgery (VATS) or thoracotomy procedures.

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Section: Discussionmentioning

confidence: 99%

Sound‐guided assessment and localization of pulmonary air leak

Pinezich

Mir

Reimer

et al. 2022

Bioengineering & Transla Med

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“…Surely to be dismissed as inferior and niche, thermography shares several features of other “disruptive” technologies that have eventually come to replace their predecessors [ 19 ]. In the field of anesthesiology and critical care medicine, there have been many trials to estimate various kinds of vital signs using non-invasive measurement techniques, such as electrocardiography [ 20 ], pulse transit time [ 21 ], and phonocardiography [ 22 – 25 ]. Although we acknowledged that these techniques are still under development, we believe that all of these studies, including the present study, will improve patient safety and well-being in the near future.…”

Section: Discussionmentioning

confidence: 99%

Non-contact thermography-based respiratory rate monitoring in a post-anesthetic care unit

Kwon

Ikeda

Kim

et al. 2020

J Clin Monit Comput

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In patients at high risk of respiratory complications, pulse oximetry may not adequately detect hypoventilation events. Previous studies have proposed using thermography, which relies on infrared imaging, to measure respiratory rate (RR). These systems lack support from real-world feasibility testing for widespread acceptance. This study enrolled 101 spontaneously ventilating patients in a post-anesthesia recovery unit. Patients were placed in a 45° reclined position while undergoing pulse oximetry and bioimpedance-based RR monitoring. A thermography camera was placed approximately 1 m from the patient and pointed at the patient’s face, recording continuously at 30 frames per second for 2 min. Simultaneously, RR was manually recorded. Offline imaging analysis identified the nares as a region of interest and then quantified nasal temperature changes frame by frame to estimate RR. The manually calculated RR was compared with both bioimpedance and thermographic estimates. The Pearson correlation coefficient between direct measurement and bioimpedance was 0.69 (R 2 = 0.48), and that between direct measurement and thermography was 0.95 (R 2 = 0.90). Limits of agreement analysis revealed a bias of 1.3 and limits of agreement of 10.8 (95% confidence interval 9.07 to 12.5) and − 8.13 (− 6.41 to − 9.84) between direct measurements and bioimpedance, and a bias of −0.139 and limits of agreement of 2.65 (2.14 to 3.15) and − 2.92 (− 2.41 to 3.42) between direct measurements and thermography. Thermography allowed tracking of the manually measured RR in the post-anesthesia recovery unit without requiring patient contact. Additional work is required for image acquisition automation and nostril identification. Electronic supplementary material The online version of this article (10.1007/s10877-020-00595-8) contains supplementary material, which is available to authorized users.

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“…Moon et al [ 3 ] present a new acoustic based monitoring device to assist in evaluation of tracheal accumulation of secretions. In a retrospective analysis, they performed power spectral analysis of sound recordings from an oesophageal stethoscope in 20 surgical patients split between 9 with documented intraoperative removal of secretion and 11 with documentation of no respiratory disease as well as no secretions during surgery.…”

Section: Acoustic Monitoring Of Airway Patencymentioning

confidence: 99%

“…This study found that fewer endotracheal suctioning as well as unnecessary endotracheal suctioning were performed in the suctioning by acoustic indication group, although it appears that the commercial device used in this study is no longer available. It would be interesting to see if the new device and method presented in a small preliminary study by Moon et al [ 3 ] could be further developed for practical use in surgery as well as in the intensive care setting for detection of secretion build up.…”

Section: Acoustic Monitoring Of Airway Patencymentioning

confidence: 99%

What is new in respiratory monitoring?

Karbing

Leonhardt

Perchiazzi

et al. 2022

J Clin Monit Comput

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This paper provides a review of a selection of papers published in the Journal of Clinical Monitoring and Computing in 2020 and 2021 highlighting what is new within the field of respiratory monitoring. Selected papers cover work in pulse oximetry monitoring, acoustic monitoring, respiratory system mechanics, monitoring during surgery, electrical impedance tomography, respiratory rate monitoring, lung ultrasound and detection of patient-ventilator asynchrony.

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Detection of intratracheal accumulation of thick secretions by using continuous monitoring of respiratory acoustic spectrum: a preliminary analysis

Cited by 8 publications

References 20 publications

Sound‐guided assessment and localization of pulmonary air leak

Sound‐guided assessment and localization of pulmonary air leak

Non-contact thermography-based respiratory rate monitoring in a post-anesthetic care unit

What is new in respiratory monitoring?

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