Print Email Facebook Twitter From the seashore to the stratosphere: A step closer to continuous lung monitoring using wearable ultrasound Title From the seashore to the stratosphere: A step closer to continuous lung monitoring using wearable ultrasound: Lung sliding quantification Author Visser, Jeffrey (TU Delft Mechanical, Maritime and Materials Engineering) Contributor van Westerloo, D. (mentor) Lopez Matta, J.E. (mentor) Pham, H. (graduation committee) de Jonge, E. (graduation committee) Elzo Kraemer, C. (mentor) Dekker, R. (graduation committee) Degree granting institution Delft University of TechnologyUniversiteit LeidenErasmus Universiteit Rotterdam Programme Technical Medicine Date 2022-03-01 Abstract Background: The prevention of ventilator-induced lung injury (VILI) is an important topic in criticalcare. Lung overdistention is a great attributor to VILI. Regional evaluation of the pulmonary mechanicsis a relatively new method and is currently being studied using electrical impedance tomography (EIT)and computed tomography (CT). However, ultrasonography may be an effective alternative tomeasure lung overdistention by quantifying lung sliding.Objective: The primary aim of this study was to explore if lung sliding can be quantified using in-housemade speckle tracking algorithms. Second, the usability of lung sliding quantification to detect lungoverdistention was investigated.Methods: Two speckle tracking algorithms were built and validated to quantify lung sliding. Adultpatients admitted to the ICU were prospectively examined using ultrasound. Ultrasound images wereanalyzed offline using the in-house developed Fourier-Based Speckle Tracking algorithm (FBST) andthe Intensity-Based Speckle Tracking algorithm (IBST). The performance of the best algorithm wasvalidated against the manual evaluation of lung sliding by experts and validated against lungcompliance. Besides, the performance of the best algorithm was investigated by reproducibilitytesting. Finally, we tested the algorithm for its ability to detect lung overdistention.Results: The FBST algorithm could not reliably quantify lung sliding and was not further evaluated.However, the IBST algorithm showed an overall success rate of 88%. Moreover, the IBST algorithmdifferentiated normal and moderate lung sliding with a mean IBST score of 12.1 and 29, respectively(p<0.001). A positive correlation was measured between IBST score and lung compliance (β 0.15, SE0.025, 95% CI 0.101-0.208, p <0.001). The reproducibility test calculated a relative standard error of2.7. Finally, a difference was found in IBST scores between patients with a PEEP value <12 and ≥12with a mean ± SD of 20.9 ± 7 and 12.6 ± 6, p < 0.05, respectively.Conclusion: The IBST algorithm enables a robust lung sliding quantification. The IBST scores correlatewell with expert opinion and lung compliance, but the reliability needs improvement. Our results showthat detection of lung overdistention using ultrasound is feasible. Further clinical studies should assessif ultrasonography can measure lung overdistention. Subject LungMonitoringARDSWearablesUltrasoundCOVID-19Lung slidingQuantification To reference this document use: http://resolver.tudelft.nl/uuid:7e7e96da-91b1-4bdb-b7d6-7b1fefd5c462 Part of collection Student theses Document type master thesis Rights © 2022 Jeffrey Visser Files PDF Master_thesis_Lungsliding_final.pdf 6.98 MB Close viewer /islandora/object/uuid:7e7e96da-91b1-4bdb-b7d6-7b1fefd5c462/datastream/OBJ/view