Evaluation of nocturnal bronchoconstriction by all night tracheal sound monitoring.

Lenclud, Christine; Cuttitta, Giuseppina; Gansbeke, Daniel Van; Visconti, A.; Muylem, Alain Van; Bellia, Vincenzo; Yernault, Jean Claude

doi:10.1136/thx.51.7.694

Cited by 12 publications

(7 citation statements)

References 27 publications

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“…The correlation coefficient between the W% score and the number of wheezes detected by listening was 0.72 (p<0.001), with a wide scattering. A large number of wheezes detected by the analyser were not detected by listening [27].…”

Section: Automated Characterization and Quantification Of Wheezesmentioning

confidence: 93%

Wheezes

Meslier¹,

Charbonneau²,

Racineux³

1995

Eur Respir J

159

116

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Wheezes are continuous adventitious lung sounds. The American Thoracic Society Committee on pulmonary nomenclature define wheezes as high-pitched continuous sounds with a dominant frequency of 400 Hz or more. Rhonchi are characterized as low-pitched continuous sounds with a dominant frequency of about 200 Hz or less. The large variability in the predominant frequency of wheezes is one of the difficulties encountered with automated analysis and quantification of wheezes. The large variations observed in automated wheeze characterization emphasize the need for standardization of breath sound analysis. This standardization would help determine diagnostic criteria for wheeze identification. The mechanism of wheeze production was first compared to a toy trumpet whose sound is produced by a vibrating reed. The pitch of the wheeze is dependent on the mass and elasticity of the airway walls and on the flow velocity. More recently, a model of wheeze production based on the mathematical analysis of the stability of airflow through a collapsible tube has been proposed. According to this model, wheezes are produced by the fluttering of the airways walls and fluid together, induced by a critical airflow velocity. Many circumstances are suitable for the production of continuous adventitious lung sounds. Thus, wheezes can be heard in several diseases, not only asthma. Wheezes are usual clinical signs in patients with obstructive airway diseases and particularly during acute episodes of asthma. A relationship between the degree of bronchial obstruction and the presence and characteristics of wheezes has been demonstrated in several studies. The best result is observed when the degree of bronchial obstruction is compared to the proportion of the respiratory cycle occupied by wheeze (tw/ttot). However, the relationship is too scattered to predict forced expiratory volume in one second (FEV1) from wheeze duration. There is no relationship between the intensity or the pitch of wheezes and the pulmonary function. The presence or quantification of wheezes have also been evaluated for the assessment of bronchial hyperresponsiveness. Wheeze detection cannot fully replace spirometry during bronchial provocation testing but may add some interesting information. Continuous monitoring of wheezes might be a useful tool for evaluation of nocturnal asthma and its treatment.

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Section: Automated Characterization and Quantification Of Wheezesmentioning

confidence: 93%

Wheezes

Meslier¹,

Charbonneau²,

Racineux³

1995

Eur Respir J

159

116

View full text Add to dashboard Cite

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“…Baughman and Loudon 6 recorded breath sounds in 5 patients overnight on an intermittent basis and found most wheezes to be between 0400 and 0430. Lenclud et al 7 monitored overnight tracheal sounds and airways resistance using esophageal balloon and facemask in 7 patients with nocturnal asthma and found a correlation between wheezing and airway resistance only in the more severe cases.…”

Section: Introductionmentioning

confidence: 98%

Nocturnal Wheeze Measurement in Young Asthmatics

Bentur¹,

Beck²,

Irving³

et al. 2004

Pediatric Asthma, Allergy & Immunology

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Nocturnal exacerbation is one of the criteria for defining asthma severity. The aim of this study was to look at the relationship between subjective complaints of nocturnal asthma symptoms, objectively recorded wheezing, and spirometry values. Continuous overnight recording and analysis of respiratory sounds were performed in the homes of 12 young asthmatic patients (7 male), aged 7-18 years, who reported symptoms when seen in clinic. Patients kept an asthma symptom diary for 1 week. They had spirometry the evening before and the morning after the nighttime study. Wheezing was identified and quantified by an FFT-based computer algorithm. Seven patients reported nocturnal asthma symptoms the next morning. Three patients had sustained wheezing episodes lasting 21, 25, and 36 minutes, respectively. They all had a morning FEV 1 Յ 51% predicted, whereas none of the 10 without wheezing had a morning FEV 1 Յ 51% predicted. Two of them reported nocturnal asthma and one did not. There was a significant relationship between night-time wheezing and lower FEV 1 the next morning by both parametric (unpaired t-test, p ‫؍‬ 0.004) and nonparametric (Mann-Whitney, p ‫؍‬ 0.009) tests, and between night-time wheezing and larger diurnal variation in FEV 1 (p ‫؍‬ 0.038, p ‫؍‬ 0.036, respectively). There was no significant relationship between subjective complaints of nocturnal asthma and objective measurement of wheezing or the FEV 1 the evening before the nocturnal study. Night-time wheeze was associated with a morning FEV 1 Յ 51% predicted and more pronounced diurnal variation of FEV 1 . Recalled nocturnal symptoms may not necessarily reflect wheezing and may reflect chest tightness or other sensations. Computerized acoustic monitoring provides objective evaluation of night-time wheezing.

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“…In patients with chronic airflow obstruction, the unforced wheezing score was correlated with the degree of airflow obstruction 10 . The severity of tracheal sounds in wheezing was closely correlated to nocturnal bronchoconstriction assessed by airway resistance 13 . Thus, our finding that many patients with asthma, including asymptomatics, have nocturnal wheezing along with reduced peak expiratory flow indicates that bronchoconstriction is likely to occur during sleep.…”

Section: Discussionmentioning

confidence: 61%

“…Wheezing with unforced breathing is correlated with severity of airflow obstruction 10 . Researchers have also used nocturnal wheezing recorded in the laboratory to monitor nocturnal bronchoconstriction 11 –13 …”

Section: Introductionmentioning

confidence: 99%

Detection of nocturnal wheezing in bronchial asthma using intermittent sleep tracheal sounds recording

et al. 1999

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Common clinical features of bronchial asthma include bronchoconstriction during the night, particularly while asleep. Although bronchoconstriction reduces the quality of life and can cause life-threatening events, a clinical technique for evaluating bronchoconstriction during sleep has not been widely applied. In this study, we measured nocturnal wheezing by intermittent sleep tracheal sounds recording (ISTSR) to detect bronchoconstriction during the hours of sleep. Using ISTSR, we studied the number and duration of nocturnal wheezing episodes in 27 adult patients with bronchial asthma. Nocturnal wheezing was detected in 36 of 39 recordings. Although the pattern of hourly nocturnal wheezing count (hourly NWC pattern) varied among subjects, there appeared to be a reproducible pattern within individuals. When wheezing alternated between long and short duration, bronchoconstriction tended to be more severe. The NWC in 1 h (NWC/H) was positively correlated with subjective symptoms and inversely correlated with the morning per cent peak expiratory flow. The hourly NWC was significantly greater at 05:00 than that at midnight. Intermittent sleep tracheal sounds recording has potential to be a non-invasive clinical tool for detecting nocturnal bronchoconstriction during hours of sleep in patients with asthma.

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Evaluation of nocturnal bronchoconstriction by all night tracheal sound monitoring.

Cited by 12 publications

References 27 publications

Wheezes

Wheezes

Nocturnal Wheeze Measurement in Young Asthmatics

Detection of nocturnal wheezing in bronchial asthma using intermittent sleep tracheal sounds recording

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