Acoustic monitoring of the artificial airway--experimental results.

Abstract

Non-invasive acoustic airway-monitoring was evaluated in an experimental study. Recording amplitude and travel time of acoustic pulse response, an acoustic pattern of airway's geometry was then calculated. Measurements on models and excised human cadaver lungs were performed to discover whether displacement or obstruction of the artificial airway could be detected by its acoustic equivalent. Regression analysis revealed a close correlation between displacement of tracheostomy tubes and the shifting of the acoustic area-distance function (corr. coeff.: 0.97-1) and an adequate correlation between acoustic and planimetrical determination of cross-sectional area within the tubes (corr. coeff.: 0.78). Dispersion analysis confirmed reasonable reliability of acoustic cross-sectional measurements (Coefficients of variation: 0.6-2.1%). The acoustic mapping thus provides an excellent approximation of the true displacement and/or obstruction of tracheostomy and endotracheal tubes. We conclude that acoustic monitoring may provide a helpful tool for achieving an early warning system of airway disturbancies in intubated and mechanically ventilated patients, as geometrical changes of airway configuration may be detected before they lead to relevant effects on respiratory metabolism.