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TECHNOLOGY, COMPUTING, AND SIMULATION

Acoustic Monitoring of Double-Lumen Ventilated Lungs for the Detection of Selective Unilateral Lung Ventilation

Shai Tejman-Yarden, MD^*, Dror Lederman, MSc, Israel Eilig, MD, Alexander Zlotnik, MD, Nathan Weksler, MD, Arnon Cohen, PhD (RIP), and Gabriel M. Gurman, MD

From the *Division Of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel; Department of Electrical and Computer Engineering, Ben Gurion University of the Negev, Beer Sheva, Israel; and Division of Anesthesiology and Critical Care, Soroka Medical Center, Beer Sheva, Israel.

Address correspondence and reprint requests to Shai Tejman-Yarden, MD, Division of Pediatrics, Soroka Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84101, Israel. Address e-mail to teyman{at}bgumail.bgu.ac.il or tegmanya{at}inter.net.il.

One-lung intubation (OLI) is among the most common complications of endotracheal intubation. None of the monitoring tools now available has proved effective for its early detection. In this study we investigated the efficacy of acoustic analysis for the detection of OLI. We collected lung sounds from 11 patients undergoing thoracic surgery requiring the placement of a double-lumen tube. Recordings of separate lung ventilation were performed after induction and confirmation of adequate tube positioning, before surgery. Samples of lung sounds were collected by three piezoelectric microphones, one on each side of the chest and one on the right forearm, for background noise sampling. The samples were filtered, the signals’ energy envelopes were calculated, and segmentation to breath and rest periods was performed. Each respiration was classified into one of the three categories: bilateral ventilation, selective right-lung ventilation, or selective left-lung ventilation, on the basis of the ratio between the energy signals of each lung. OLI was accurately identified in 10 of the 11 patients during right OLI and in all 11 patients during left OLI. This study suggests that acoustic monitoring is effective for the detection of selective lung ventilation and may be useful for early diagnosis of OLI.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999