Vibration Response Imaging in medical-surgical ICU

The new method of monitoring lung func-tion (“vibration response imaging”- VRI) converts vibration energy that appears in the bronchial tree during airflow into an image. The VRI does not use energy that could have a detrimental effect on the cells and organs. The goal of our research was to verify the VRI device in the diagnosis and the localization of various lung patholo-gies. In our medical-surgical ICU we did a retrospective analysis of the prospective database that included 61 patients. We compare VRI with chest X-ray and CT scan in patients with intrathoracic (the presence of air and fluid in the intrapleural space, pulmonary hypoventilation, atelec-tasis, contusion and inflammatory lung pathology) or extrathoracic pathology that affect respiratory function. 

Intrathoracic pathology was observed in 32 patients and extrathoracic pathology in 29 patients. The use of the VRI device showed earlier disorder of hypoventilation compared to chest X-ray, especially after abdominal surgical procedures, intraab-dominal hypertension and various lung pathology as it detected laterobasal pneu-mothorax earlier. 

In our patients VRI has been proven to be a reliable method for detecting regional distribution of ventilation and atelectasis of the lungs of individual parts regardless of pulmonary pathology. VRI is shown as a reliable method for detecting air and fluid in the intrapleural space.

Vibration response imaging, lung, ventilation

1. Costa ELV, Lima RG, Amato MBP. Electrical impedance tomography. Curr Opin Crit Care 2009;15:18–24.

2. Becker DH: Vibration response imaging – finally a real stetoscope. Respiration 2009;77:236-239.

3. Dellinger RP, Parrillo JE, Kushnir A, Rossi M, Kushnir I. Dynamic Visualization of lung sounds with a vibration response device: A case series. Respiration 2008;75:60–72. 

4. Guntupalli KK, Reddy RM, Loutfi RH, Alapat PM, Bandi VD, Hanania NA. Evaluation of obstructive lung disease with vibration response imag-ing. J Asthma 2008;45:923-930. 

5. Becker HD, Slawik M, Miyazawa T, Gat M. Vibration response imaging as a new tool for interventional-bronchoscopy outcome assessment: a prospective pilot study. Respiration 2009;77:179-194. 

6. Blanco M, Mor R, Fraticelli A, Breen DP, Dutau H. Distribution of breath sound images in patients with peumothoraces compared to healthy subjects. Respiration 2009; 77:173-178. 

7. Anantham D, Herth FJ, Majid A, Michaud G, Ernst A. Vibration response imaging in the detection of pleural effusions: a feasibility study. Respira-tion 2009;77:166-72. 

8. Dellinger RP, Jean S, Cinel I, Tay C, Rajanala S, Glickman YA, Parrillo JE. Regional distribution of acoustic-based lung vibration as a function of mechanical ventilation mode. Crit Care 2007;11(1):R26.

9. Lev S, Glickman YA, Kagan I, Dahan D, Cohen J, Grinev M, Shapiro M, Singer P. Changes in regional distribution of lung sounds as a function of positive end-expiratory pressure. Crit Care 2009;13(3):R66.

10. Trivedi H, Cinel I, Jean S, Tay C, Durflinger P, Parrillo JE, Dellinger RP. The role of vibration response imaging in the titration of PEEP in a me-chanically ventilated patient with acute respiratory distress syndrome. Crit Care Med 2006;34(12):A170.