Acoustic effects of positive end‐expiratory pressure on normal lung sounds in mechanically ventilated pigs

Abstract

Computerized lung sounds analysis offers a new technique to monitor regional ventilation during spontaneous breathing. The purpose of the present study was to assess the acoustic behaviour of the respiratory system in healthy pigs during mechanical ventilation when a positive end-expiratory pressure (PEEP) is applied. Lung sounds were recorded during mechanical ventilation and different PEEP levels of 0, 5, 10, 15 and 20 cm H(2)O were applied. The increase in end-expiratory lung volume (EELV) related to the PEEP application was also measured and the correlation between changes in EELV (DeltaEELV) and sound amplitude (DeltaA) was examined. The amplitude of normal lung sounds was reduced by application of PEEP >or=10 cm H(2)O (P<0.05). The increase in PEEP from 0 to 20 cm H(2)O reduced the acoustic energy of lung sounds recorded at ZEEP by 0.3 dB (PEEP 5), 2 dB (PEEP 10), 5 dB (PEEP 15) and 7 dB (PEEP 20), which corresponds to 1%, 6%, 14% and 21% in acoustic attenuation, respectively. The variations in DeltaA correlated with changes in lung volume (P<0.05) and with changes in compliance of the respiratory system (P<0.05), but were not correlated with changes of the resistance of respiratory system. The frequency analysis showed a downward shifting of the spectra at frequencies between 150 and 600 Hz for PEEP levels >or=10 cm H(2)O and frequencies between 75 and 600 Hz for PEEP levels >or=15 cm H(2)O. The application of increasing levels of PEEP reduced the amplitude and changed the spectral characteristics of normal lung sounds.