PURPOSE: Vibration response imaging (VRI) is a technique that measures the vibration energy of lung sounds. This technology can be utilized in diagnosis and severity assessment of lung disease, including asthma, and therefore may be useful in guiding therapy and making disposition decisions in the Emergency Department (ED) setting. Utilizing VRI technology, we investigated changes in the breathing profile following treatment in acute asthmatics.
METHODS: 13 asthmatic patients (5 males; age 45±11years) underwent evaluation in the ED with the VRI before and after treatment for acute asthma exacerbation. Dynamic development of breathing features (graph amplitude; synchrony of right and left lungs at peak inspiration/expiration and vibration energy fluctuations between lungs) were evaluated for left and right lungs separately. The presence of wheezes was also identified using the device algorithm.
RESULTS: Breathing profile was different following treatment and tended to improve towards a healthy profile. Asynchrony between right and left lungs during exacerbation decreased in 77% (10/13) patients after treatment (mean±Std dev = 0.15±0.09 vs. 0.09±0.09 msec; p=0.10). Fluctuations in dominant lung sound intensity improved in nine patients (42±15 vs. 39±15). Wheezes were significantly reduced following treatment (p<0.05) and higher energy graph amplitude showed a trend in reduction, though not statistically significant (0.4±0.2 vs. 0.3±0.1.
CONCLUSIONS: Respiratory patterns from VRI recordings are considerably different in acutely obstructed asthmatics compared to breathing profiles after treatment.
CLINICAL IMPLICATIONS: Improvement in non-standard breathing patterns, such as asynchrony between the lungs and higher energy graph amplitude, as well as the presence of abnormal breath sounds on VRI recordings, may provide an additional tool for the treatment of asthma in the ED setting, as the breathing pattern moves from an acute acoustical profile towards a normal one. VRI may afford a novel objective means of assessing acute response to therapy in asthma exacerbation.
DISCLOSURE: Muhammad Waseem: Grant monies (from industry related sources): Funding from Deep Breeze as an investigator
Toussaint Reynolds: Grant monies (from industry related sources): Funding from Deep Breeze as an investigator
Fernando Jara: Grant monies (from industry related sources): Funding from Deep Breeze as an investigator
Merav Gat: Employee: Employee Deep Breeze Company
Doran Rozen: Employee: Employee Deep Breeze Company
Charles Pollack: Grant monies (from industry related sources): Funding from Deep Breeze as an investigator
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