Pneumothorax Detection Using Pulmonary Acoustic Transmission Measurements

Overview

Journal Med Biol Eng Comput

Publisher Springer

Specialties Biomedical Engineering
Medical Informatics

Date 2002 Nov 28

PMID 12452411

Citations 14

Authors

H A Mansy

T J Royston

R A Balk

R H Sandler

Affiliations

Soon will be listed here.

Abstract

Pneumothorax is a common clinical condition that can be life threatening. The current standard of diagnosis includes radiographic procedures that can be costly and may not always be readily available or reliable. The objective of this study was to investigate the hypothesis that pneumothorax causes detectable pathognomonic changes in pulmonary acoustic transmission. An animal model was developed whereby 15 mongrel dogs were anaesthetised, intubated and mechanically ventilated. A thoracoscopic trocar was placed into the pleural space for the introduction of air and confirmation of a approximately 30% pneumothorax by direct visualisation. Broadband acoustic signals were introduced into the endotracheal tube, while transmitted waves were measured at the chest surface. Pneumothorax was found consistently to lower the pulmonary acoustic transmission in the 200-1200 Hz frequency band, whereas smaller transmission changes occurred at lower frequencies (p< 0.0001, sign test). The ratio of acoustic energy between low-(< 220 Hz) and high-(550-770 Hz) frequency bands was significantly different in the control and pneumothorax states (p < 0.0001, sign test). This implies that pneumothoraces can be reliably detected using pulmonary acoustic transmission measurements in the current animal model. Further studies are needed to investigate the feasibility of using this technique in humans.

Citing Articles

Sound transmission in human thorax through airway insonification: an experimental and computational study with diagnostic applications.

Palnitkar H, Henry B, Dai Z, Peng Y, Mansy H, Sandler R Med Biol Eng Comput. 2020; 58(10):2239-2258.

PMID: 32666412 PMC: 7501255. DOI: 10.1007/s11517-020-02211-y.

Acoustic Methods for Pulmonary Diagnosis.

Rao A, Huynh E, Royston T, Kornblith A, Roy S IEEE Rev Biomed Eng. 2018; 12:221-239.

PMID: 30371387 PMC: 6874908. DOI: 10.1109/RBME.2018.2874353.

Modeling Inspiratory Flow in a Porcine Lung Airway.

Gamage P, Khalili F, Khurshidul Azad M, Mansy H J Biomech Eng. 2017; 140(6).

PMID: 29131890 PMC: 6993782. DOI: 10.1115/1.4038431.

Generation of Pig Airways using Rules Developed from the Measurements of Physical Airways.

Azad M, Mansy H J Bioeng Biomed Sci. 2017; 6(4).

PMID: 28255517 PMC: 5330366. DOI: 10.4172/2155-9538.1000203.

Geometric features of pig airways using computed tomography.

Azad M, Mansy H, Gamage P Physiol Rep. 2016; 4(20).

PMID: 27798351 PMC: 5099960. DOI: 10.14814/phy2.12995.

References

Kollef M . Risk factors for the misdiagnosis of pneumothorax in the intensive care unit. Crit Care Med. 1991; 19(7):906-10. DOI: 10.1097/00003246-199107000-00014. View

Kraman S, Austrheim O . Comparison of lung sound and transmitted sound amplitude in normal men. Am Rev Respir Dis. 1983; 128(3):451-4. DOI: 10.1164/arrd.1983.128.3.451. View

Royston T, Zhang X, Mansy H, Sandler R . Modeling sound transmission through the pulmonary system and chest with application to diagnosis of a collapsed lung. J Acoust Soc Am. 2002; 111(4):1931-46. DOI: 10.1121/1.1452742. View

Sahn S, Heffner J . Spontaneous pneumothorax. N Engl J Med. 2000; 342(12):868-74. DOI: 10.1056/NEJM200003233421207. View

Tocino I, Miller M, Fairfax W . Distribution of pneumothorax in the supine and semirecumbent critically ill adult. AJR Am J Roentgenol. 1985; 144(5):901-5. DOI: 10.2214/ajr.144.5.901. View

Ludwig J, Kienzle G . Pneumothorax in a large autopsy population. A study of 77 cases. Am J Clin Pathol. 1978; 70(1):24-6. DOI: 10.1093/ajcp/70.1.24. View

Wodicka G, Stevens K, Golub H, Cravalho E, Shannon D . A model of acoustic transmission in the respiratory system. IEEE Trans Biomed Eng. 1989; 36(9):925-34. DOI: 10.1109/10.35301. View

Despars J, Sassoon C, Light R . Significance of iatrogenic pneumothoraces. Chest. 1994; 105(4):1147-50. DOI: 10.1378/chest.105.4.1147. View

DONNERBERG R, Druzgalski C, Hamlin R, Davis G, Campbell R, Rice D . Sound transfer function of the congested canine lung. Br J Dis Chest. 1980; 74(1):23-31. View

10.

Meller J, Little A, Shermeta D . Thoracic trauma in children. Pediatrics. 1984; 74(5):813-9. View

11.

Ciraulo D, Elliott D, Mitchell K, Rodriguez A . Flail chest as a marker for significant injuries. J Am Coll Surg. 1994; 178(5):466-70. View

12.

Haake R, Schlichtig R, Ulstad D, Henschen R . Barotrauma. Pathophysiology, risk factors, and prevention. Chest. 1987; 91(4):608-13. DOI: 10.1378/chest.91.4.608. View

13.

Wodicka G, Aguirre A, DeFrain P, Shannon D . Phase delay of pulmonary acoustic transmission from trachea to chest wall. IEEE Trans Biomed Eng. 1992; 39(10):1053-9. DOI: 10.1109/10.161337. View

14.

Baumann M, Strange C, Heffner J, Light R, KIRBY T, Klein J . Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest. 2001; 119(2):590-602. DOI: 10.1378/chest.119.2.590. View

15.

GIERKE H, OESTREICHER H, FRANKE E, PARRACK H, WITTERN W . Physics of vibrations in living tissues. J Appl Physiol. 1952; 4(12):886-900. DOI: 10.1152/jappl.1952.4.12.886. View

16.

Wodicka G, Shannon D . Transfer function of sound transmission in subglottal human respiratory system at low frequencies. J Appl Physiol (1985). 1990; 69(6):2126-30. DOI: 10.1152/jappl.1990.69.6.2126. View

17.

Athanassiadi K, Kalavrouziotis G, Loutsidis A, Hatzimichalis A, Bellenis I, Exarchos N . Surgical treatment of spontaneous pneumothorax: ten-year experience. World J Surg. 1998; 22(8):803-6. DOI: 10.1007/s002689900473. View

18.

Mansy H, Royston T, Sandler R . Acoustic characteristics of air cavities at low audible frequencies with application to pneumoperitoneum detection. Med Biol Eng Comput. 2001; 39(2):159-67. DOI: 10.1007/BF02344798. View