Clinical lung and heart/lung transplantation
Regional Breath Sound Distribution Analysis in Single-lung Transplant Recipients

https://doi.org/10.1016/j.healun.2007.07.039Get rights and content

Background

Perfusion scintigraphy has been used to evaluate and monitor graft function in single-lung transplant recipients. In this study, our objective was to determine whether quantitatively measured regional breath sounds, using a computerized breath sound analysis device, correlate with the standard methods of monitoring graft function used at our facility for single-lung transplant patients.

Methods

Quantitative regional breath sound measurements (QLD VRI) were performed with a VRIxp device on 37 single-lung transplant patients, who underwent perfusion scans and lung function testing for routine follow-up. The measurements were conducted on the same day.

Results

Using a quantitative output based on objectively measured breath sounds, we established that there is good correlation (0.73) between QLD VRI and perfusion measurements for the grafted lung. Moreover, no significant differences were found between the two measurements (p = 0.898, t-test for paired data). In addition, the fraction of forced expiratory volume in 1 second (FEV1; liters) of the graft lung was measured twice: once as a function of FEV1 and regional perfusion and then as a function of FEV1 and QLD VRI. High correlation (r = 0.88) and no significant differences (p = 0.72) were found between FEV1tx (perfusion) and FEV1tx (QLD VRI). Absolute error was 0.13 liter and the root-mean-square error (RMSE) was 0.17 liter.

Conclusions

Objectively measured breath sound distribution in single-lung transplant patients can be readily quantified and correlated with graft function measurements. The method is quick and non-invasive and may provide useful information to aid clinicians in managing single-lung transplant patients.

Section snippets

Study Population

We examined a total of 37 patients (18 males, 19 females) in stable condition after SLT (18 left lungs, 19 right lungs), who presented to our hospital for routine follow-up. All patients were evaluated after SLT (mean ± SD: 27 ± 24 months after transplantation; range, 1 month to 118 months; median, 20 months).

The study population comprised only patients in good clinical condition with normal graft function and neither evidence nor suspicion of acute or chronic rejection or infections. For the

Results

Of the 37 patients examined, 17 presented with emphysema and 20 with pulmonary fibrosis (average age of all patients, 60 ± 6 years [± SD]; range, 45 to 75 years). The mean FEV1 predicted at the time of the study was 58 ± 16% (range, 30% to 96%). Actual FEV1 average was 1.5 ± 0.4 liters (range, 0.8 to 2.5 liters).

Distribution to the graft lung was 75% ± 14% (confidence interval [CI] 69% to 80%) and 75 ± 16% (CI 70% to 79%) for perfusion and VRI QLD, respectively. No significant differences were

Discussion

This study has demonstrated a good correlation (r = 0.73) between VRI QLD and perfusion distribution to the graft lungs in SLT recipients. No significant differences were found (p > 0.05, t-test for paired data) between the two measurements for the graft lung analysis; absolute error was 9% and the RMSE was 11%. In addition, the fraction of FEV1 (liters) of the transplanted lung was measured twice: once as a function of FEV1 and regional perfusion, and then as a function of FEV1 and QLD VRI. A

References (23)

  • R. Hardoff et al.

    The prognostic value of perfusion lung scintigraphy in patients who underwent single-lung transplantation for emphysema and pulmonary fibrosis

    J Nucl Med

    (2000)

    • Cited by (0)

    View full text
    Copyright © 2007 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.