Lung Sound Analysis in the Diagnosis of Obstructive Airway DiseaseWang Z.a, c · Jean S.a · Bartter T.b
Divisions of aCritical Care Medicine and bPulmonary and Critical Care, Robert Wood Johnson School of Medicine, University of Medicine and Dentistry of New Jersey, Cooper University Hospital, Camden, N.J., USA; cDepartment of Emergency Medicine, Peking University Third Hospital, Beijing, China
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Background: Dyspnea is prevalent and has a broad differential diagnosis. Difficulty in determining the correct etiology can delay proper treatment. Non-invasively obtained acoustic signals may offer benefit in identifying patients with dyspnea due to obstructive airway disease (OAD). Objectives: The aim of this pilot study was to determine whether patients with acute dyspnea due to OAD had distinguishing features when studied with a computerized acoustic-based imaging technique. Methods: Respiratory sounds from patients with dyspnea due to OAD (n = 32) and those with dyspnea not due to OAD (n = 39) were studied and compared with normal controls (n = 16). Results: In patients without OAD and in controls, the ratios of peak inspiratory to peak expiratory vibration energy values (peak I/E vibration ratio) were remarkably similar, 6.3 ± 5.1 and 5.6 ± 4, respectively. For the OAD patients, the peak I/E vibration ratio was significantly lower at 1.3 ± 0.04 (p < 0.01). In the patients without OAD and the controls, the ratios of inspiratory time to expiratory time (I/E time ratio) were again similar, 1.0 ± 0.1 and 0.99 ± 0.11, respectively. For the OAD patients, the I/E time ratio was significantly lower at 0.72 ± 0.19 (p < 0.01). Conclusions: This modality was useful in identifying patients whose dyspnea was due to OAD. The ability to objectively and non-invasively measure these differences may prove clinically useful in distinguishing the operant physiology in patients presenting with acute dyspnea.
© 2008 S. Karger AG, Basel
McCaig LF, Nawar EW: Division of Health Care Statistics National Hospital Ambulatory Medical Care Survey: 2004 emergency department summary. Adv Data 2006; 372:1–29.
- McCord J, Nowak RM, McCullough PA, Foreback C, Borzak S, Tokarski G, Tomlanovich MC, Jacobsen G, Douglas W: Ninety-minute exclusion of acute myocardial infarction by use of quantitative point-of-care testing of myoglobin and troponin I. Circulation 2001;104:1483–1488.
National Heart, Lung and Blood Institute, National Asthma Education and Prevention Program. Expert panel report 3: guidelines for the diagnosis and management of asthma. Full report 2007. http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm.
- Mannino DM: COPD: epidemiology, prevalence, morbidity and mortality, and disease heterogeneity. Chest 2002;121:121S–126S.
- Hoffman JR, Reynolds S: Comparison of nitroglycerin, morphine and furosemide in the treatment of presumed pre-hospital pulmonary edema. Chest 1987;92:586–593.
- Wuerz RC, Meador SA: Effects of prehospital medications on mortality and length of stay in congestive heart failure. Ann Emerg Med 1992;21:669–674.
- Trzeciak S, Rivers EP: Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emerg Med J 2003;20:402–405.
- Chalfin DB, Trzeciak S, Likourezos A, Baumann BM, Dellinger RP, for the DELAY-ED study group: Impact of delayed transfer of critically ill patients from the emergency department to the intensive care unit. Crit Care Med 2007;35:1477–1483.
Congestive heart failure and pulmonary edema. www.emedicine.com/EMERG/topic108.
Braunwald E, Zipes DP, Libby P: Heart Disease: A Textbook of Cardiovascular Medicine, ed 6. Philadelphia, Saunders, 2000.
Loudon HG, Murphy RLH: Lung sounds; in Crystal RG, West JB, Barnes PJ, Cherniack NS, Weibel ER (eds): The Lung. New York, Raven Press, 1991, pp 1011–1019.
- Schreur HJ, Vanderschoot J, Zwinderman AH, Dijkman JH, Sterk PJ: Abnormal lung sounds in patients with asthma during episodes with normal lung function. Chest 1994;106:91–99.
- Loudon RG: The lung exam. Clin Chest Med 1987;8:265–272.
- Ertel PY, Lawrence M, Brown RK, Stern AM: Stethoscope acoustics. 1. The doctor and his stethoscope. Circulation 1966;34:889–898.
- Pasterkamp H, Kraman S, Wodicka GR: Respiratory sounds. Advances beyond the stethoscope. Am J Respir Crit Care Med 1997;156:974–987.
- Dellinger RP, Jean S, Cinel I, Tay C, Rajanala S, Glickman YA, Parrillo JE: Regional distribution of acoustic-based lung vibration as a function of mechanical ventilation mode. Crit Care 2007;11:R26.
- Dellinger RP, Parrillo JE, Kushnir A, Rossi M, Kushnir I: Dynamic visualization of lung sounds with a vibration response device: a case series. Respiration 2008;75:60–72.
- Sharma V, Shaaban AM, Berges G, Gosselin M: The radiological spectrum of small-airway diseases. Semin Ultrasound CT MR 2002;23:339–351.
- Sung A, Naidich D, Belinskaya I, Raoof S: The role of chest radiography and computed tomography in the diagnosis and management of asthma. Curr Opin Pulm Med 2007;13:31–36.
- Tgavalekos NT, Tawhai M, Harris RS, Musch G, Vidal-Melo M, Venegas JG, Lutchen KR: Identifying airways responsible for heterogeneous ventilation and mechanical dysfunction in asthma: an image functional modeling approach. J Appl Physiol 2005;99:2388–2397.
- Tanaka R, Sanada S, Okazaki N, Kobayashi T, Fujimura M, Yasui M, Matsui T, Nakayama K, Nanbu Y, Matsui O: Evaluation of pulmonary function using breathing chest radiography with a dynamic flat panel detector: primary results in pulmonary diseases. Invest Radiol 2006;41:735–745.
Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care. 2004. www.nice.org.uk/ CG012NICEguideline.
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