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Tracheal sounds accurately detect apnea in patients recovering from anesthesia

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Abstract

Apnea should be monitored continuously in the post anesthesia care unit (PACU) to avoid serious complications. It has been confirmed that tracheal sounds can be used to detect apnea during sedation in healthy subjects, but the performance of this acoustic method has not been evaluated in patients with frequent apnea events in the PACU. Tracheal sounds were acquired from the patients in the PACU using a microphone encased in a plastic bell. Concurrently, a processed nasal pressure signal was used as a reference standard to identify real respiratory events. The logarithm of the tracheal sound variance (log-var) was used to detect apnea, and the results were compared to the reference method. Sensitivity, specificity, positive likelihood ratios (PLR), and negative likelihood ratios (NLR) were calculated. One hundred and twenty-one patients aged 55.5 ± 13.2 years (mean ± SD) with a body mass index of 24.6 ± 3.7 kg/m2 were included in data analysis. The total monitoring time was 52.6 h. Thirty-four patients experienced 236 events of apnea lasting for a total of 122.2 min. The log-var apnea detection algorithm detected apnea with 92% sensitivity, 98% specificity, 46 PLR and 0.08 NLR. The performance of apnea detection in the PACU using the log-var tracheal sounds method proved to be reliable and accurate. Tracheal sounds could be used to minimize the potential risks from apnea in PACU patients.

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Funding

This study was funded by the National Natural Science Foundation of China, Beijing, P.R. China (Grant No. 81401485).

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Author notes

  1. Jing Liu and Chunyu Ai have contributed equally to this work.

Authors and Affiliations

  1. Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, No. 77, Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, People’s Republic of China

    Jing Liu & Lu Yu

  2. Department of Anesthesiology, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, People’s Republic of China

    Chunyu Ai, Bowen Zhang & Yun Wang

  3. Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA

    Lara M. Brewer

  4. Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, 11217, Taiwan, ROC

    Chien-Kun Ting

  5. Department of Mathematics, School of Fundamental Sciences, China Medical University, Shenyang, Liaoning, People’s Republic of China

    Desheng Huang

Authors
  1. Jing Liu
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  2. Chunyu Ai
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  3. Bowen Zhang
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  4. Yun Wang
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  6. Chien-Kun Ting
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  7. Desheng Huang
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  8. Lu Yu
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Correspondence to Lu Yu.

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Liu, J., Ai, C., Zhang, B. et al. Tracheal sounds accurately detect apnea in patients recovering from anesthesia. J Clin Monit Comput 33, 437–444 (2019). https://doi.org/10.1007/s10877-018-0192-6

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  • DOI: https://doi.org/10.1007/s10877-018-0192-6

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