Continuous Monitoring Versus Intermittent Auscultation of Wheezes in Patients Presenting with Acute Respiratory Distress

Background: Auscultation for an extended pe-riod of time using a wearable stethoscope enables objective computerized analysis and longitudinal assessment of lung sounds. However, this auscultation method differs from bed-side auscultation in that clinicians are not present to opti-mize the quality of auscultation. No prior studies have com-pared these two auscultation methods. Objective: The aim of this study was to compare intermittent auscultation using a conventional stethoscope with continuous auscultation using a wearable stethoscope for wheeze detection in patients who present with acute respiratory distress. Methods: Patients presenting to the emergency department with acute respira-tory distress were enrolled. The Strados Remote Electronic Stethoscope Platform (RESPTM) was used for continuous auscultation, and intermittent auscultation was performed using a U.S. Food and Drug Administration-cleared elec-tronic stethoscope. A recording was made with an electronic stethoscope. Subsequently, continuous recording was made using RESPTM, which continued until the patient was ad-mitted or discharged from the emergency department. The number of captured wheezes in each recording was counted and validated by two board-certified physicians. Results: From May 2018 to May 2019, 43 patients were enrolled in the study. Three patients were excluded from analysis due to incomplete audio recording data. The mean length of record-ing was 62.3 min for continuous auscultation and 0.7 min for intermittent auscultation; 77.5% (31 of 40) of intermit-tent recordings contained wheezes, in contrast to 85% (34 of 40) of continuous recordings. Conclusions: Extending the duration of auscultation using a wearable stethoscope in a noisy clinical environment showed comparable performance to standard of care intermittent auscultation in identifying patients who have wheezes. (c) 2022 Elsevier Inc. All rights reserved.