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Critical Care
Published in: Critical Care 3/2009

Open Access 01-06-2009 | Research

Changes in regional distribution of lung sounds as a function of positive end-expiratory pressure

Authors: Shaul Lev, Yael A Glickman, Ilya Kagan, David Dahan, Jonathan Cohen, Milana Grinev, Maury Shapiro, Pierre Singer

Published in: Critical Care | Issue 3/2009

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Abstract

Introduction

Automated mapping of lung sound distribution is a novel area of interest currently investigated in mechanically ventilated, critically ill patients. The objective of the present study was to assess changes in thoracic sound distribution resulting from changes in positive end-expiratory pressure (PEEP). Repeatability of automated lung sound measurements was also evaluated.

Methods

Regional lung sound distribution was assessed in 35 mechanically ventilated patients in the intensive care unit (ICU). A total of 201 vibration response imaging (VRI) measurements were collected at different levels of PEEP between 0 and 15 cmH2O. Findings were correlated with tidal volume, oxygen saturation, airway resistance, and dynamic compliance. Eighty-two duplicated readings were performed to evaluate the repeatability of the measurement.

Results

A significant shift in sound distribution from the apical to the diaphragmatic lung areas was recorded when increasing PEEP (paired t-tests, P < 0.05). In patients with unilateral lung pathology, this shift was significant in the diseased lung, but not as pronounced in the other lung. No significant difference in lung sound distribution was encountered based on level of ventilator support needed. Decreased lung sound distribution in the base was correlated with lower dynamic compliance. No significant difference was encountered between repeated measurements.

Conclusions

Lung sounds shift towards the diaphragmatic lung areas when PEEP increases. Lung sound measurements are highly repeatable in mechanically ventilated patients with various lung pathologies. Further studies are needed in order to fully appreciate the contribution of PEEP increase to diaphragmatic sound redistribution.
Appendix
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Metadata
Title
Changes in regional distribution of lung sounds as a function of positive end-expiratory pressure
Authors
Shaul Lev
Yael A Glickman
Ilya Kagan
David Dahan
Jonathan Cohen
Milana Grinev
Maury Shapiro
Pierre Singer
Publication date
01-06-2009
Publisher
BioMed Central
Published in
Critical Care / Issue 3/2009
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc7871

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