Robust heart sound detection in respiratory sound using LRT with maximum a posteriori based online parameter adaptation

Tracheal Sound Analysis for Automatic Detection of Respiratory Depression in Adult Patients during Cataract Surgery under Sedation

Background

Tracheal sound analysis is a simple way to study the abnormalities of upper airway like airway obstruction. Hence, it may be an effective method for detection of alveolar hypoventilation and respiratory depression. This study was designed to investigate the importance of tracheal sound analysis to detect respiratory depression during cataract surgery under sedation. Methods: After Institutional Ethical Committee approval and informed patients' consent, we studied thirty adults American Society of Anesthesiologists I and II patients scheduled for cataract surgery under sedation anesthesia. Recording of tracheal sounds started 1 min before administration of sedative drugs using a microphone. Recorded sounds were examined by the anesthesiologist to detect periods of respiratory depression longer than 10 s. Then, tracheal sound signals converted to spectrogram images, and image processing was done to detect respiratory depression. Finally, depression periods detected from tracheal sound analysis were compared to the depression periods detected by the anesthesiologist.

Results

We extracted five features from spectrogram images of tracheal sounds for the detection of respiratory depression. Then, decision tree and support vector machine (SVM) with Radial Basis Function (RBF) kernel were used to classify the data using these features, where the designed decision tree outperforms the SVM with a sensitivity of 89% and specificity of 97%.

Conclusions

The results of this study show that morphological processing of spectrogram images of tracheal sound signals from a microphone placed over suprasternal notch may reliably provide an early warning of respiratory depression and the onset of airway obstruction in patients under sedation.

Adaptive Sojourn Time HSMM for Heart Sound Segmentation

Heart sounds are difficult to interpret due to events with very short temporal onset between them (tens of milliseconds) and dominant frequencies that are out of the human audible spectrum. Computer-assisted decision systems may help but they require robust signal processing algorithms. In this paper, we propose a new algorithm for heart sound segmentation using a hidden semi-Markov model. The proposed algorithm infers more suitable sojourn time parameters than those currently suggested by the state of the art, through a maximum likelihood approach. We test our approach over three different datasets, including the publicly available PhysioNet and Pascal datasets. We also release a pediatric dataset composed of 29 heart sounds. In contrast with any other dataset available online, the annotations of the heart sounds in the released dataset contain information about the beginning and the ending of each heart sound event. Annotations were made by two cardiopulmonologists. The proposed algorithm is compared with the current state of the art. The results show a significant increase in segmentation performance, regardless the dataset or the methodology presented. For example, when using the PhysioNet dataset to train and to evaluate the HSMMs, our algorithm achieved average an F-score of [Formula: see text] compared to [Formula: see text] achieved by the algorithm described in [D.B. Springer, L. Tarassenko, and G. D. Clifford, "Logistic regressionHSMM-based heart sound segmentation," IEEE Transactions on Biomedical Engineering, vol. 63, no. 4, pp. 822-832, 2016]. In this sense, the proposed approach to adapt sojourn time parameters represents an effective solution for heart sound segmentation problems, even when the training data does not perfectly express the variability of the testing data.

Heart Sound Localization in Respiratory Sound Based on a New Computationally Efficient Entropy Bound

A new entropy bound with low computational complexity for differential Shannon entropy estimation with kernel density approach is proposed in this study, which is based on defining a bound for the Kullback-Leibler divergence between two Gaussian mixture models. The proposed entropy bound is derived to provide computational efficiency without decreasing the accuracy in detecting heart sound segments in respiratory sound. It is shown both theoretically and experimentally that using the proposed bound in an adaptive threshold-based detection method gives very similar performance compared to that obtained by a nonparametric kernel based approach, while its computational cost is much lower. The performance of the proposed method is shown and compared with the three methods in the literature by means of experiments utilizing a database of 20 subjects. The results show that the false negative rate values for the proposed method are 1.45±1.50 % and 1.98±1.81 % for low and medium flow rates, respectively. These average values are similar to the results obtained by the alternative methods. Moreover, the average elapsed time of the proposed method for a piece of data with a length of 20 s is 0.05 s, which is significantly lower than that of the other methods.