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ORIGINAL ARTICLE
Year : 2018  |  Volume : 8  |  Issue : 3  |  Page : 140-146

Tracheal sound analysis for automatic detection of respiratory depression in adult patients during cataract surgery under sedation


1 Department of Bioelectrics and Biomedical Engineering, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences; Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Anesthesia, Isfahan University of Medical Sciences, Isfahan, Iran
3 Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Biomedical Engineering, Faculty of Medicine, McGill University, Quebec, Canada
4 Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Correspondence Address:
Mahmoud Saghaei
Department of Anesthesia, Isfahan University of Medical Sciences, Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmss.JMSS_67_16

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Background: Tracheal sound analysis is a simple way to study the abnormalities of upper airway like airway obstruction. Hence, it may be an effective method for detection of alveolar hypoventilation and respiratory depression. This study was designed to investigate the importance of tracheal sound analysis to detect respiratory depression during cataract surgery under sedation. Methods: After Institutional Ethical Committee approval and informed patients' consent, we studied thirty adults American Society of Anesthesiologists I and II patients scheduled for cataract surgery under sedation anesthesia. Recording of tracheal sounds started 1 min before administration of sedative drugs using a microphone. Recorded sounds were examined by the anesthesiologist to detect periods of respiratory depression longer than 10 s. Then, tracheal sound signals converted to spectrogram images, and image processing was done to detect respiratory depression. Finally, depression periods detected from tracheal sound analysis were compared to the depression periods detected by the anesthesiologist. Results: We extracted five features from spectrogram images of tracheal sounds for the detection of respiratory depression. Then, decision tree and support vector machine (SVM) with Radial Basis Function (RBF) kernel were used to classify the data using these features, where the designed decision tree outperforms the SVM with a sensitivity of 89% and specificity of 97%. Conclusions: The results of this study show that morphological processing of spectrogram images of tracheal sound signals from a microphone placed over suprasternal notch may reliably provide an early warning of respiratory depression and the onset of airway obstruction in patients under sedation.


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