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Sound Analysis in an In Vitro Endotracheal Tube Model

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Background/Aims: Complete endotracheal tube obstruction is a medical emergency, and partial occlusion causes increased breathing rates and failure to wean off mechanical ventilation. Partial occlusion may be underestimated due to the lack of proper detection methods. We tested whether the sound of an endotracheal tube could be used to detect an endotracheal tube obstruction using an in vitro model. Methods: An endotracheal tube was connected to a ventilator on one end and a test lung on the other. Sounds were recorded with a microphone located inside the endotracheal tube via a connector. During mechanical ventilation, we changed the endotracheal tube internal diameter from 5.0 to 8.0 mm and different grades of obstruction at different sites were used along the tube. Sound energy was compared among the different conditions. Results: The energy of endotracheal tube sounds was positively correlated with the internal diameter and negatively correlated with the degree of obstruction. The rate of decline in energy differed with obstruction location. When the obstruction was more distal, the rate of decline in endotracheal sound energy was more rapid. Conclusions: Changes in the sound of an endotracheal tube can be used to detect an obstruction. Further studies are needed for clinical application.

Abstract

Background/Aims: Complete endotracheal tube obstruction is a medical emergency, and partial occlusion causes increased breathing rates and failure to wean off mechanical ventilation. Partial occlusion may be underestimated due to the lack of proper detection methods. We tested whether the sound of an endotracheal tube could be used to detect an endotracheal tube obstruction using an in vitro model. Methods: An endotracheal tube was connected to a ventilator on one end and a test lung on the other. Sounds were recorded with a microphone located inside the endotracheal tube via a connector. During mechanical ventilation, we changed the endotracheal tube internal diameter from 5.0 to 8.0 mm and different grades of obstruction at different sites were used along the tube. Sound energy was compared among the different conditions. Results: The energy of endotracheal tube sounds was positively correlated with the internal diameter and negatively correlated with the degree of obstruction. The rate of decline in energy differed with obstruction location. When the obstruction was more distal, the rate of decline in endotracheal sound energy was more rapid. Conclusions: Changes in the sound of an endotracheal tube can be used to detect an obstruction. Further studies are needed for clinical application.

참고문헌 (17)

  1. Boque MC, "Endotracheal tube intraluminal diameter narrowing after mechanical ventilation: use of acoustic reflectometry", Intensive Care Med, 30, pp.2204~2209 (2004)
  2. Shah C, "Endotracheal tube intraluminal volume loss among mechanically ventilated patients", Crit Care Med, 32, pp.120~125 (2004)
  3. Ramirez P, "Prevention measures for ventilator- associated pneumonia: a new focus on the endotracheal tube", Curr Opin Infect Dis, 20, pp.190~197 (2007)
  4. Adair CG, "Implications of endotracheal tube biofilm for ventilator-associated pneumonia", Intensive Care Med, 25, pp.1072~1076 (1999)
  5. Feldman C, "The presence and sequence of endotracheal tube colonization in patients undergoing mechanical ventilation", Eur Respir J, 13, pp.546~551 (1999)
  6. Tung A, "Modeling the effect of progressive endotracheal tube occlusion on tidal volume in pressure-control mode", Anesth Analg, 95, pp.192~197 (2002)
  7. Kawati R, "Peak airway pressure increase is a late warning sign of partial endotracheal tube obstruction whereas change in expiratory flow is an early warning sign", Anesth Analg, 100, pp.889~893 (2005)
  8. Kawati R, "Change in expiratory flow detects partial endotracheal tube obstruction in pressurecontrolled ventilation", Anesth Analg, 103, pp.650~657 (2006)
  9. Jarreau PH, "Detection of positional airway obstruction in neonates by acoustic reflection", Am J Respir Crit Care Med, 161, pp.1754~1756 (2000)
  10. Schumann S, "Detection of partial endotracheal tube obstruction by forced pressure oscillations", Respir Physiol Neurobiol, 155, pp.227~233 (2007)
  11. Visaria RK, "Model-based detection of partially obstructed endotracheal tube", Crit Care Med, 33, pp.149~154 (2005)
  12. Sovijarvi AR, "Standardization of computerized respiratory sound analysis", Eur Respir Rev, 10, pp.585~ (2000)
  13. Oppenheim AV, "Singals and Systems. 2nd ed" (1997), Prentice-Hall
  14. Oppenheim AV, "Discrete-Time Signal Processing" (1989), Prentice-Hall
  15. Elad D, "Time-frequency analysis of breathing signals: in vitro airway model", Technol Health Care, 9, pp.269~280 (2001)
  16. Raphael DT, "Acoustic reflectometry profiles of endotracheal and esophageal intubation", Anesthesiology, 92, pp.1293~1299 (2000)
  17. Raphael DT, "Validation study of two-microphone acoustic reflectometry for determination of breathing tube placement in 200 adult patients", Anesthesiology, 97, pp.1371~1377 (2002)

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