title: Brief report: pulmonary auscultation in the operating room: a prospective randomized blinded trial comparing electronic and conventional stethoscopes.
abstract: BACKGROUND
  We compared the subjective quality of pulmonary auscultation between 2 acoustic stethoscopes (Holtex Ideal® and Littmann Cardiology III®) and an electronic stethoscope (Littmann 3200®) in the operating room.
  
  
  METHODS
  A prospective double-blind randomized study with an evaluation during mechanical ventilation was performed in 100 patients. After each examination, the listeners using a numeric scale (0-10) rated the quality of auscultation. Auscultation quality was compared in patients among stethoscopes with a multilevel mixed-effects linear regression with random intercept (operator effect), adjusted on significant factors in univariate analysis. A significant difference was defined as P < 0.05.
  
  
  RESULTS
  One hundred comparative evaluations of pulmonary auscultation were performed. The quality of auscultation was rated 8.2 ± 1.6 for the electronic stethoscope, 7.4 ± 1.8 for the Littmann Cardiology III, and 4.6 ± 1.8 for the Holtex Ideal. Compared with Holtex Ideal, auscultation quality was significantly higher with other stethoscopes (P < 0.0001). Compared with Littmann Cardiology III, auscultation quality was significantly higher with Littmann 3200 electronic stethoscope (β = 0.9 [95% confidence interval, 0.5-1.3]).
  
  
  CONCLUSIONS
  An electronic stethoscope can provide a better quality of pulmonary auscultation than acoustic stethoscopes in the operating room, yet with a magnitude of improvement marginally higher than that provided with a high performance acoustic stethoscope. Whether this can translate into a clinically relevant benefit requires further studies.
authors.affiliation: From the Department of Anesthesiology and Intensive Care Medicine, Percy Military Teaching Hospital, Clamart; French Military Institute of Biomedical Research Brétigny-sur-Orge; Department of Anesthesiology and Intensive Care Medicine, Begin Military Teaching Hospital, Saint Mandé Burns Treatment Center, Percy Military Teaching Hospital, Clamart; Emergency Medical Service, Paris Fire Brigade, Paris; and Department of Anesthesiology and Intensive Care Medicine, Val-de-Grace Military Teaching Hospital, Paris, France.
authors.forename: Clement
authors.initials: C
authors.lastname: Hoffmann
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Falzone
authors.forename: Catherine
authors.initials: C
authors.lastname: Verret
authors.forename: Pierre
authors.initials: P
authors.lastname: Pasquier
authors.forename: Thomas
authors.initials: T
authors.lastname: Leclerc
authors.forename: Nicolas
authors.initials: N
authors.lastname: Donat
authors.forename: Daniel
authors.initials: D
authors.lastname: Jost
authors.forename: Stephane
authors.initials: S
authors.lastname: Mérat
authors.forename: Guillaume de Saint
authors.initials: GS
authors.lastname: Maurice
authors.forename: Bernard
authors.initials: B
authors.lastname: Lenoir
authors.forename: Yves
authors.initials: Y
authors.lastname: Auroy
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Tourtier
mesh_terms: D000328:Adult; D000368:Aged; D001314:Auscultation / Q000295:instrumentation*; D004311:Double-Blind Method; D004581:Electronics; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D016014:Linear Models; D008168:Lung / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D011446:Prospective Studies; D019023:Stethoscopes