This invention relates to medical devices and methods and more specifically, to such devices and methods for analyzing respiratory tract function.
Spirometry is a common test of respiratory function that involves measuring the total volume of air inhaled into the lungs over a respiratory cycle. A spirometry test is usually carried out by having a subject inhale air through a tube connected to an air flow meter that measures the total volume of air inhaled during the inspiration phase of the respiratory cycle. At the termination of the inspiration phase the subject exhales through the tube. A curve is generated showing the air flow as a function of time. The curve is analyzed to obtain one or more respiratory parameters of the subject that are used to assess intrathorax airways obstruction. For example, the so-called “forced expiratory volume in one second” (FEV1) is obtained in a test performed during a maximum effort force expiratory vital capacity maneuver started from total lung capacity. FEV1 is a well characterized test of respiratory function and provides useful information in diseased and normal states. In chronic obstructive pulmonary disease, the level of FEV1 is used to grade the severity of the obstruction.
It is known to attach a plurality of microphones to a subject's chest or back in order to record respiratory tract sounds at a plurality of locations on the body surface. U.S. patent application Ser. No. 10/338,742 published on Jan. 9, 2003, and having the Publication No. US 2003-0139679 discloses a method for analyzing respiratory tract sounds detected by a plurality of microphones affixed to a subject's back or chest. The recorded sound signals are processed to determine an average acoustical energy {tilde over (P)}(x,t1,t2) at a plurality of locations x on the body surface over a time interval from t1 to t2.
The present invention is based on the finding that the average acoustic energy over a region of an individual's back or chest or during a time interval from t1 to t2, can be correlated with the air flow in the portion of the respiratory tract underlying the region during that time interval. Thus, in its first aspect the invention provides a method for calculating an air flow in at least a portion of an individual's respiratory tract. In accordance with this aspect of the invention, a plurality of microphones is fixed onto a subject's back or chest over the portion of the respiratory tract, and respiratory tract sounds are recorded from the region over a time interval from t0 to t1. An average acoustical energy during the subinterval is determined at a plurality of locations x in the region. The total average acoustical energy, summed over the locations x is then correlated with the airflow in the portion of the respiratory tract. In a presently preferred embodiment, an airflow is calculated that is equal to the logarithm of the total acoustic energy. The process may then be repeated during the expiratory phase of the respiratory cycle.
The airflow during each subinterval obtained by the method of the invention, may be displayed in the form of a graph of the airflow as a function of time over a respiratory cycle.
The airflow in the lungs as a function of time during the inspiratory phase obtained in accordance with the invention may be integrated from a time t0 to a time t to produce a total volume of air that has flowed into the airways from time t0 to t. The airflow at a time t may be plotted as a function of the total volume of air that has flowed into the airways from t0 to time t, to produce a spirometry curve for inspiration. The process may then be repeated for the expiratory phase of the respiratory cycle. Thus, in its first aspect, the invention provides a method for determining airflow in a portion of a respiratory tract comprising determining a total acoustic energy in a region of a body surface overlying the portion of the respiratory tract.
In its second aspect, the invention provides a system for determining airflow in a portion of a respiratory tract comprising a processor configured to determine a total acoustic energy in a region of a body surface overlying the portion of the respiratory tract.
In order to understand the invention and to see how it may be carried out in practice, a preferred embodiment will now be described, by way of non-limiting example only, with reference to the accompanying drawings, in which:
a shows a spirometry curve for both lungs of an individual, and
An input device such as a computer keyboard 140 or mouse 145 is used to input relevant information relating to the examination such as personal details of the individual 110. The input device 140 may also be used to input a subdivision of the time interval t0 to tm into subintervals t0, t1, t2, . . . tm. Alternatively, the times t2, . . . tm−1 may be determined automatically by the processor 135. The processor 135 determines an average acoustic energy {tilde over (P)}(x,ti,ti+1) over each subinterval from ti to ti+1, i=0 to m−1. at a plurality of locations x in the region R in a calculation involving at least one of the signals P(xi,t).
The average acoustic energies are stored in the memory 130 and may be displayed on a display device 150 such as a CRT screen for diagnosis by a physician.
The processor is also configured to integrate the functions {tilde over (P)}(x,ti,ti+1) with respect to x
in order to obtain a total flow rate of air in the airways during the interval from ti to ti+1. The processor is also configured to integrate the functions
with respect to time,
in order to obtained the total volume of air that has flowed in the airways from t0 to tk, for each k from 1 to m.
The processor is also configured to display on the display device a spirometry curve which is a plot of the flow rate
during the interval from ti to ti+1 as a function of the volume
suring the same time interval.
The processor 135 may also perform an automatic differential diagnosis by comparing the spirometry curve to standard spirometry curves functions stored in the memory and known to be indicative of various disorders in the body region.
In step 210, the processor integrates the functions {tilde over (P)}(x,ti,ti+1) with respect to x,
in order to obtain a total flow rate of air in the airways during the interval from ti to ti+1. In step 215, the processor integrates the functions
with respect to time,
in order to obtained the total volume of air that has flowed in the airways from t0 to tk, for each k from 1 to m. In step 220, the processor displays on the display device a spirometry curve which is a plot of the flow rate
as a function of the volume
It will also be understood that the system according to the invention may be a suitably programmed computer. Likewise, the invention contemplates a computer program being readable by a computer for executing the method of the invention. The invention further contemplates a machine-readable memory tangibly embodying a program of instructions executable by the machine for executing the method of the invention.
A plurality of 20 sound transducers were applied to an individual's back over each lung. Each transducer produced an analog voltage signal indicative of pressure waves arriving to the transducer over a respiratory cycle. The analog signals were digitized by a multichannel analog to digital converter. The digital data signals P(xi,t), represent the pressure wave at the location xi of the ith transducer at time t. The data signals were denoised by filtering components having frequencies outside of the range of respiratory sounds.
The respiratory cycle was divided into 0.1 sec subintervals and the subintervals were classified as belonging to either the inspiratory or the expiratory phase of the respiratory cycle. An average acoustic energy was calculated {tilde over (P)}(x,ti,ti+1) over each subinterval [ti, ti+1] at a plurality of locations x over each lung from the signals P(xi,t).
For each lung, the functions {tilde over (P)}(x,ti,ti+1) were integrated with respect to x
in order to obtain a total airflow in the lung during the interval from ti to ti+1. The integrals
were then integrated with respect to time,
in order to obtain a function that can be correlated with the total volume of air that has flowed into or out of each lung during the inspiratory and the expiratory phase, respectively, from the onset of the phase to a variable time tk. The logarithm of these integrals were calculated and plotted as a function of time during the respiratory cycle in order to obtain a spirometry curve. The results are shown in