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IS VIBRATION RESPONSE IMAGING (VRI) USEFUL FOR DETECTION OF HIGH ALTITUDE PULMONARY EDEMA (HAPE)?

Thoraxklinik at Heidelberg University, Heidelberg, Germany

PURPOSE: With increase of mountain hiking HAPE might become a more common problem. Besides heredetary factors, 10% of the normal population are considered to develop pulmonary hypertension under hypoxemia. We investigated, whether these persons are also at risk for developing HAPE and wheter this can be detected by VRI.

METHODS: In a first group 23 individuals climbed the Margherita hut at 4559m within 24h and stayed there for 48h. Besides physical examination, spirometry, blood gases, echo cardiography and x-ray as gold standards (GS) VRI, a computer based, non-invasive and radiation free device was applied. It provides dynamic real-time images of the lung and quantitative data by recording vibrations from the chest wall, using 40 piezoelectric sensors and converting the signals to dynamic grey scale images.

RESULTS: In a first group 23 persons were screened at sea level and 3 showed minor changes in the VRI. 11/16 completed the study. 2 developed HAPE, diagnosed by GS and VRI. 1 had a positive VRI and suspicion by GS, 2 were suspected by both, 2 positive by VRI and negative by GS, 3 negative by both and 2 negative by VRI but suspected by GS.

CONCLUSION: From these results, VRI might have a high sensitivity in detecting fluid collections in the lung at an eraly stage. The algorithms for analyzing the dynamic images and the quantitative data are currently revised and applied in a second group from Zurich, that subsequently climbed the hut.

CLINICAL IMPLICATIONS: If the VRI can be proven to be highly sensitive for early detection of fluid collections within the lung it could become a useful, non-invasive and radiation free bedside method for management of cardiac failure in the ED and ICU.

DISCLOSURE: Heinrich Becker, No Financial Disclosure Information; No Product/Research Disclosure Information