The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

VIBRATION RESPONSE IMAGING: A BEDSIDE LEARNING EXPERIENCE

Quan M. Nguyen, Laura Withers, Clarence Finch, Jorge Rodriguez, Kristen J. Price; Respiratory Care, MD Anderson Cancer Center, Houston, TX

Background: Vibration Response Imaging (VRI) is a radiation-free and non-invasive imaging technology that uses pulmonary airflow to generate dynamic images of the lungs using an array (consisting of 36 individual acoustic sensors, similar to stethoscopes) placed on the patient’s back. The sensors record the vibrations produced by airflow in the lungs and convert them into images. Using the same data, VRI is also able to determine graphically the Vibration Energy Distribution (VED) which represents the distribution of energy for the right and the left lungs into 3 different regions: upper, middle and lower.We conducted VRI studies in our intensive care unit to study the feasibility of the technique in critically ill cancer patients. Methods: VRI was performed in critically ill mechanically ventilated (MV) patients. The patients were chosen randomly, and also included those with non-uniform chest x-ray findings. The arrays were arranged on the bed by lifting the patients and, then lowering the patients on to the arrays with adjustments made as needed to ensure adequate contact with the array-sensors. Before positioning the arrays under the patient, the arrays were placed in a disposable positioning unit (DPU) in order to protect the patient’s skin and decrease the risk of infection due to cross contamination. Results: VRI was performed in six patients. Each study included three to four separate images. The studies were done with the patient in semi-fowler’s position in the first three cases. One of the studies performed in semi-fowler’s position was done without a DPU. All studies performed with the patient in supine position had arrays placed in a DPU. In order to correlate airway pressure and flow, the GE Carestation ventilators were used along with the D-lite flow sensors. Conclusions: VRI can be performed in the MV patients in the ICU in any position with extreme care taken in order to optimize image quality. Appropriate positioning of the array of acoustic sensors under the patient requires careful adjustment during patient positioning in order to ensure adequate patient contact with the array sensors. The use of a DPU and its design are important considerations for optimum use of this technology since these factors can affect the quality of the images. Further studies are required to study the usefulness of VRI for real time assessment of lung function in critically ill patients on mechanical ventilation. Sponsored Research - None

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