Zuiki Masashi, Hasegawa Tatsuji, Ohshimo Shinichiro, Iehara Tomoko, Shime Nobuaki
Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, JPN.
Department of Emergency and Critical Care Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, JPN.
Cureus. 2024 Jul 25;16(7):e65394. doi: 10.7759/cureus.65394. eCollection 2024 Jul.
The assessment of auscultation using a stethoscope is unsuitable for continuous monitoring. Therefore, we developed a novel acoustic monitoring system that continuously, objectively, and visually evaluates respiratory sounds. In this report, we assess the usefulness of our revised system in a ventilated extremely low birth weight infant (ELBWI) for the diagnosis of pulmonary atelectasis and evaluation of treatment by lung lavage. A female infant was born at 24 weeks of age with a birth weight of 636 g after emergency cesarean section. The patient received invasive mechanical ventilation immediately after birth in our neonatal (NICU). After obtaining informed consent, we monitored her respiratory status using the respiratory-sound monitoring system by attaching a sound collection sensor to the right anterior chest wall. On day 26, lung-sound spectrograms showed that the breath sounds were attenuated simultaneously as hypoxemia progressed. Finally, chest radiography confirmed the diagnosis as pulmonary atelectasis. To relieve atelectasis, surfactant lavage was performed, after which the lung-sound spectrograms returned to normal. Hypoxemia and chest radiographic findings improved significantly. On day 138, the patient was discharged from the NICU without complications. The continuous respiratory-sound monitoring system enabled the visual, quantitative, and noninvasive detection of acute regional lung abnormalities at the bedside. We, therefore, believe that this system can resolve several problems associated with neonatal respiratory management and save lives.
使用听诊器进行听诊评估不适用于连续监测。因此，我们开发了一种新型声学监测系统，该系统可对呼吸音进行连续、客观且可视化的评估。在本报告中，我们评估了我们改进后的系统在一名接受机械通气的极低出生体重儿（ELBWI）中用于诊断肺不张及评估肺灌洗治疗效果的实用性。一名女婴在孕24周时经紧急剖宫产出生，出生体重636克。出生后，该患儿立即在我们的新生儿重症监护病房（NICU）接受有创机械通气。在获得知情同意后，我们通过将声音采集传感器附着于右前胸壁，使用呼吸音监测系统对其呼吸状况进行监测。在第26天，肺音频谱图显示随着低氧血症的进展，呼吸音同时减弱。最终，胸部X线检查确诊为肺不张。为缓解肺不张，进行了表面活性剂灌洗，之后肺音频谱图恢复正常。低氧血症和胸部X线检查结果显著改善。在第138天，患儿无并发症地从NICU出院。连续呼吸音监测系统能够在床边对急性局部肺部异常进行可视化、定量且无创的检测。因此，我们认为该系统能够解决与新生儿呼吸管理相关的若干问题并挽救生命。
