Changes in Frequency Spectra of Breath Sounds During Histamine Challenge Test in Adult Asthmatics and Healthy Control Subjects

Malmberg, L. Pekka; Sovijärvi, Anssi; Paajanen, Erkki; Piirilä, Päivi; Haahtela, Tari; Katila, T.

doi:10.1378/chest.105.1.122

Cited by 68 publications

(31 citation statements)

References 20 publications

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“…This is the first study in which lung sound characteristics have been examined during acutely induced airways obstruction using airflow-and volume-standardized phonopneumography and flow-dependent lung sound analysis. The results are in agreement with earlier studies in which intensity [18,19], pitch [18][19][20][21], and wheezing in children [22][23][24] and adults [20,25,26] were increased during spontaneous or induced airways obstruction. In contrast, BOHADANA and co-workers [27,28] found that lung sound intensity was reduced during bronchoconstriction, probably due to a change in breathing pattern.…”

Section: Discussionsupporting

confidence: 93%

“…Based on the standardized breathing manoeuvres, this could be avoided in the present experiments. Breathing pattern had not been fully standardized in any of the previous studies, the analysis being based on subjective auscultation [26,27], or on computerized analysis [18][19][20][21][22][23][24][25]28], without discrimination of discrete flow-values or ascending and descending flow. Therefore, the results of the present study indicate that changes in lung sounds during acute airway narrowing do not only result from alterations in breathing pattern.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of methacholine-induced acute airway narrowing on lung sounds in normal and asthmatic subjects

Schreur

Vanderschoot²,

Zwinderman³

et al. 1995

Eur Respir J

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T Th he e e ef ff fe ec ct t o of f m me et th ha ac ch ho ol li in ne e--i in nd du uc ce ed d a ac cu ut te e a ai ir rw wa ay y n na ar rr ro ow wi in ng g o on n l lu un ng g s so ou un nd ds s i in n n no or rm ma al l a an nd d a as st th hm ma at ti ic c s su ub bj je ec ct ts s ABSTRACT: The association between lung sound alterations and airways obstruction has long been recognized in clinical practice, but the precise pathophysiological mechanisms of this relationship have not been determined. Therefore, we examined the changes in lung sounds at well-defined levels of methacholine-induced airway narrowing in eight normal and nine asthmatic subjects with normal baseline lung function. All subjects underwent phonopneumography at baseline condition and at ≥20% fall in forced expiratory volume in one second (FEV 1 ), and in asthmatic subjects also at ≥40% fall in FEV 1 . Lung sounds were recorded at three locations on the chest wall during standardized quiet breathing, and during maximal forced breathing. Airflow-dependent power spectra were computed using fast Fourier transform. For each spectrum, we determined the intensity and frequency content of lung sounds, together with the extent of wheezing. The results were analysed using analysis of variance (ANOVA).During acute airway narrowing, the intensity and frequency content of the recorded sounds, as well as the extent of wheezing, were higher than at baseline in both groups of subjects. At similar levels of obstruction, both the pitch and the change in sound intensity with airflow were higher in asthmatics than in normal subjects. Wheezing, being nondiscriminative between the subject groups at baseline, was more prominent in asthmatics than in normal subjects at 20% fall in FEV 1 .We conclude that, at given levels of acute airway narrowing, lung sounds differ between asthmatics and normal subjects. This suggests that airflow-standardized phonopneumography is a sensitive method for detecting abnormalities in airway dynamics in asthma. Our results favour the use of quiet, well-controlled breathing during auscultation.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

The effect of methacholine-induced acute airway narrowing on lung sounds in normal and asthmatic subjects

Schreur

Vanderschoot²,

Zwinderman³

et al. 1995

Eur Respir J

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“…From the recorded lung sound the following parameters were automatically calculated as an average over the whole recorded sample, inspirations and expirations separately: the frequency of maximal amplitude in the spectrum (fmax), root mean square; the amplitude of the sound of the power spectrum (RMS) [12], the (first, second and third) quartile frequencies in the power spectrum (f75, f50, f25) [12,18].…”

Section: Lung Sound Recording and Analysis Methodsmentioning

confidence: 99%

Lung sounds in asbestos induced pulmonary disorders

Piirilä¹,

Lehtola²,

Zitting³

et al. 2000

European Respiratory Journal

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The aim of the study was to compare the lung sounds in patients with asbestos related pulmonary disorders with findings in high-resolution computed tomography (HRCT), and with lung function variables, in order to find out associations of acoustic changes with radiological fibrosis, emphysema or with pulmonary gas transfer functions.Sixty-four patients with asbestos-related pleural disease, with or without pulmonary disease, were studied. Lung sound recording and analysis was carried out with a computerized lung sound analyser, and HRCT of the chest, as well as forced spirometry and diffusing capacity measurement were performed.The fibrosis score correlated positively with the quartile frequencies of the power spectrum of lung sounds in inspiration (f50) and expiration (f50) and crackle count in inspiration, as well as negatively with diffusing capacity. When the patients with crackling sounds and significant fibrosis were excluded (n=18), emphysema correlated negatively with expiratory quartile frequencies of the power spectrum, with f25 and f50. Furthermore, diffusing capacity correlated with inspiratory f25 and forced expiratory volume in one second with inspiratory f50 when crackles and fibrosis were excluded.Changes in lung sounds were significantly associated with radiologically verified abnormalities and gas transfer of pulmonary tissue. High sound frequencies were associated with fibrotic changes of the lung while low sound frequencies with pulmonary emphysema. Acoustic analysis gives complementary clinical information for evaluation of asbestos-related pulmonary disorders. Eur Respir J 2000; 16: 901±908.

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“…28 A movement of crackles to more central airways may arise as a result of forced expiratory maneuvers moving secretions and allowing more air to pass. The association between crackle classification (fine vs coarse) and the location in the airways of their generation has been previously investigated by Fredberg and Holford, 29 and has been put on a firmer basis by Majumdar et al 30 Although CALSA has not previously been used as an outcome measure for therapeutic interventions, it has been reported that it can detect changes during the course of pharmacologically induced airway obstruction, 31 during forced expiratory maneuvers, 32 and during pathological processes such as pneumonia. 6,33 Baughman and Loudon 5 recorded lung sounds in asthma patients overnight and were able to detect degrees of obstruction severity not revealed by any other measure.…”

Section: Discussionmentioning

confidence: 99%

Are Crackles an Appropriate Outcome Measure for Airway Clearance Therapy?

Marques

Bruton²,

Barney

et al. 2012

Respir Care

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BACKGROUND: There is an urgent need to develop new outcome measures for respiratory therapy, to evaluate its effectiveness. Adventitious sounds generated from the lungs (crackles and wheezes), can now be quantified and characterized objectively with computer technology. To our knowledge, this is the first reported study designed to assess any change in lung crackles before and after a single session of airway clearance therapy. METHODS: Twenty-three stable bronchiectasis patients were recruited from United Kingdom out-patient clinics and treated with a single session of airway clearance therapy, using the active cycle of breathing technique. Sound recordings were made before and after the session at 7 anatomical chest locations. Computerized lung sound analysis was used to measure crackle parameters: 2-cycle deflection width (2CD), and crackle number per breath cycle (nBC). Perceived breathlessness, lung function, and oxygen saturation data were also recorded. RESULTS: Crackle mean 2CD and mean nBC increased post intervention. Sixteen participants (70%) showed a statistically significant difference in mean crackle 2CD before and after the session at > 1 chest location. Thirteen (57%) participants had a difference between mean crackle 2CD before and after the intervention > 1 Smallest Real Difference (SRD, mean SRD ‫؍‬ 2.23 ms) at > 1 chest location. Differences in mean crackle nBC before and after the intervention did not exceed the SRD (mean SRD ‫؍‬ 32 crackles per breath cycle) in any participant. Perceived breathlessness was significantly reduced post intervention; no significant changes were observed in either lung function or oxygen saturation. CONCLUSIONS: Crackle duration (2CD) was found to change after a single session of airway clearance therapy, and shows promise as a new outcome measure for respiratory therapy interventions.

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Changes in Frequency Spectra of Breath Sounds During Histamine Challenge Test in Adult Asthmatics and Healthy Control Subjects

Cited by 68 publications

References 20 publications

The effect of methacholine-induced acute airway narrowing on lung sounds in normal and asthmatic subjects

The effect of methacholine-induced acute airway narrowing on lung sounds in normal and asthmatic subjects

Lung sounds in asbestos induced pulmonary disorders

Are Crackles an Appropriate Outcome Measure for Airway Clearance Therapy?

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