Intrapulmonary electronic auscultation for asthma and chronic obstructive pulmonary disease

The aim of the study was to develop and perform clinical testing of the intrapulmonary electronic auscultation method for audio and video recording at various levels of the tracheobronchial tree for the diagnosis of asthma and chronic obstructive pulmonary disease (COPD). Methods. We examined 31 patients with moderate (n = 17) and severe (n = 14) COPD with severe symptoms outside of exacerbation and 35 patients with moderate (n = 19) and severe (n = 16) partially controlled asthma. Traditional bronchoscopy was performed, including intrabronchial recording of acoustic noise with a microphone (introduced into the instrumental channel of the bronchoscope) at various levels of the tracheobronchial tree. Video recording in various modes revealed the causes of wheezing. At the same time, pulmonary sounds were recorded in the interscapular region of the chest at the projection points of the bronchoscope in the tracheobronchial tree using a 3M™ Littmann® 3200 electronic stethoscope (USA). Results. The greatest intergroup differences between patients with moderate and severe COPD were demonstrated by intrapulmonary sound parameters (frequency and duration of wheezing, р < 0.0001) and frequency response (amplitude-frequency characteristics) of wheezing in the lumen of the 4th order bronchi (р < 0.0001), significantly exceeded the corresponding sound phenomena during auscultation from the surface of the chest (р < 0.01). The most significant intergroup differences in the groups of BA patients with moderate and severe disease were observed in the frequency response of wheezing during intrapulmonary auscultation in the lumen of the 3rd order (р < 0.0001) and 4th order (р < 0.0001) bronchi; smaller differences were observed in the frequency response during auscultation from the chest surface (р < 0.001). Conclusion. Intrapulmonary auscultation is a modern auscultatory method which can improve the quality and efficiency of diagnosis of asthma and COPD in pulmonology.