title: Computerized lung acoustic monitoring can help to differentiate between various chest radiographic densities in critically ill patients.
abstract: BACKGROUND
  Complementary bedside lung monitoring modalities are often sought in order to assist in the differentiation between several lung opacities in the intensive care unit (ICU).
  
  
  OBJECTIVE
  To evaluate the use of computerized lung acoustic monitoring as a complementary approach in the differentiation between various chest radiographic densities in critically ill patients.
  
  
  METHODS
  Lung vibration intensity was assessed in 82 intensive care patients using vibration response imaging. Patients were classified according to their primary findings on chest radiography (CXR): consolidation (n = 35), congestion (n = 10), pleural effusion (n = 15), atelectasis/hypoinflation (n = 10) and normal findings (n = 12). Sixty patients were mechanically ventilated and 22 patients were spontaneously breathing.
  
  
  RESULTS
  Significantly elevated vibration intensity was detected in patients with consolidation, as opposed to pleural effusion, atelectasis and normal CXR (p < 0.01, Mann-Whitney U test). Vibration intensity was also increased for congestion, but this increase was not significant. The positive predictive value of CXR lung opacity in combination with increased vibration intensity to detect consolidations and/or congestions was 95% (20/21). Furthermore, vibration intensity was significantly higher in mechanically ventilated patients compared to spontaneously breathing patients (p = 0.001, Mann-Whitney U test). Differences related to gender, age and body position were not significant.
  
  
  CONCLUSIONS
  Computerized lung acoustic monitoring at the bedside was found to be a useful, readily available, noninvasive, adjunctive tool in the differentiation between various CXR densities in critically ill patients.
authors.affiliation: Department of General Intensive Care, Rabin Medical Center, Petah Tikva, Israel. lev.nirit@gmail.com
authors.forename: Shaul
authors.initials: S
authors.lastname: Lev
authors.forename: Yael A
authors.initials: YA
authors.lastname: Glickman
authors.forename: Ilya
authors.initials: I
authors.lastname: Kagan
authors.forename: Maury
authors.initials: M
authors.lastname: Shapiro
authors.forename: Osnat
authors.initials: O
authors.lastname: Moreh-Rahav
authors.forename: David
authors.initials: D
authors.lastname: Dahan
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cohen
authors.forename: Milana
authors.initials: M
authors.lastname: Grinev
authors.forename: Pierre
authors.initials: P
authors.lastname: Singer
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D012135:Respiratory Sounds