Document Detail

Breath sound changes associated with malpositioned endotracheal tubes.
MedLine Citation:
PMID:  15865129     Owner:  NLM     Status:  MEDLINE    
Endotracheal tubes (ETTs) are used to establish airway access in patients with ventilatory failure and during general anaesthesia. Tube malpositioning can compromise respiratory function and can be associated with increased morbidity and mortality. Clinical assessment of ETT position normally involves chest auscultation, which is highly skill-dependent and can be misleading. The objective of this pilot study was to investigate breath sound changes associated with ETT malpositioning. Breath sounds were acquired in six human subjects over each hemithorax and over the epigastrium for tracheal, bronchial and oesophageal intubations. When the ETT was in the oesophagus, the acoustic energy ratio between epigastrium and chest surface increased in all subjects (p < 0.04). In addition, ETT placement in the right mainstem bronchus decreased the acoustic energy ratio between the left and right hemithoraxes in all subjects (p < 0.04). A baseline measurement of this energy ratio was needed for bronchial intubation identification. However, using this ratio after bandpass filtering (200-500 Hz) did not require a baseline value, which would increase the utility of this method for initial ETT placement. These results suggest that computerised analysis of breath sounds may be useful for assessment of ETT positioning. More studies are needed to test the feasibility of this approach further.
H A Mansy; C J O'Connor; R A Balk; R H Sandler
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Medical & biological engineering & computing     Volume:  43     ISSN:  0140-0118     ISO Abbreviation:  Med Biol Eng Comput     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-05-03     Completed Date:  2005-08-01     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7704869     Medline TA:  Med Biol Eng Comput     Country:  England    
Other Details:
Languages:  eng     Pagination:  206-11     Citation Subset:  IM    
Biomedical Acoustics Research Group, Department of Pediatrics, Rush Medical College, Chicago, IL, USA.
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MeSH Terms
Foreign Bodies / diagnosis*,  etiology
Intubation, Intratracheal / adverse effects*
Pilot Projects
Respiratory Sounds / etiology*
Signal Processing, Computer-Assisted
Grant Support
61108//PHS HHS

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