Correlation between subjective and objective lung sound characteristics identified in patients undergoing upper abdominal surgery

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Correlation between subjective and objective lung sound characteristics identified in patients undergoing upper abdominal surgery

 

Author: Cheng, Pearl
Title: Correlation between subjective and objective lung sound characteristics identified in patients undergoing upper abdominal surgery
Degree: M.Sc.
Year: 2003
Subject: Hong Kong Polytechnic University -- Dissertations
Lungs -- Sounds
Abdomen -- Surgery
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: xiv, 143 leaves : ill. (some col.) ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1714730
URI: http://theses.lib.polyu.edu.hk/handle/200/1772
Abstract: Introduction: Lung auscultation (LAUS) is commonly used by physiotherapists in the assessment of the respiratory function of surgical patients. Recently, lung sounds can also be measured objectively by computerized phonopneumography (CPG). In the present study, the correlation between LAUS with CPG on the characteristics of lung sounds identified in patients undergoing upper abdominal surgery was investigated. The change of lung sound intensity, as identified by either method, before and after surgery was also investigated. Subjects: Twenty-six adult patients admitted to the surgical unit of the Queen Mary Hospital undergoing elective upper abdominal surgery participated in the present study. Methods: Characteristics of lung sounds including peak lung sound intensity, presence of crackles or wheezes, quality of crackles (fine or coarse crackles) and wheezes (high or low pitch wheezes) and the timing of occurrence (early, mid or late inspiratory or expiratory phase) over the right basal lung were recorded simultaneously by LAUS (listening by stethoscope) and CPG on the day before operation (DP), on day 1 (Dl) and then again on days (D5) postoperatively Data analysis: Spearman rank coefficient of correlation was used for the analysis of correlation between peak lung sound intensity recorded by LAUS and CPG at each time point. Contingency coefficient was used for the correlation of identification of the presence and quality of the added sounds, as well as at which phase of the respiratory cycle did the added sounds occurr at each time point. The change in peak lung sound intensity recorded by LAUS and CPG before and after surgery was analyzed by repeated measures ANOVA and Friedman two-way analysis of variance by ranks test respectively. The level of significance was set at 0.05. Results: Lung sounds recorded by LAUS suggested peak lung sound intensity decreased significantly on Dl to 32% of the preoperative level (p=0.00), then returned to 67% of the preoperative level on D5 (p=0.00). There was also a significant difference in peak lung sound intensity between DP and D5 (P=0.00). For CPG, peak lung sound intensity also decreased to 32% of the preoperative level on Dl (p=0.0l) and returned to 51% of the preoperative level on D5 (p=0. 179). There was also a significant difference in peak lung sound intensity between DP and D5 (p=0.013). The correlation of peak lung sound intensity between LAUS and CPG on DP, D1 and D5 were moderate to good (r=0.464* on DP, 0.776+ on Dl and 0.627# on D5). The correlation between LAUS and CPG in the identification of added sounds, the quality of crackles (fine or coarse crackles) and the timing of the occurrence of crackles were found to be fair to good on DP (r=0.480*, 0.596 NS and 0.703 NS) during inspiration, and good on Dl during both inspiration (r=0.761+ 0.76 1*and O.881+) and expiration (r=0.866+, 0.692# and 0.763+). In the rest of the recordings, the correlation of the identification of added sounds, their quality and timing were either poor or could not be processed by the statistical software programme. (NS-not significant; *p>=0.005,#p>=0.001,+P=>=0.001) Conclusions: Both LAUS and CPG were able to detect a significant decrease in peak lung sound intensity in patients after upper abdominal operation. LAUS has moderate to good correlation with CPG on peak lung sound intensity implying that lung auscultation with stethoscope can be taken as an accurate bedside assessment in lung sound intensity in acute ward settings. Due to the small number of incidence of added sounds identified, no reliable conclusion could be drawn from the analysis of the correlation of crackles and wheezes identified by either method

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