Wheeze monitoring in children for assessment of nocturnal asthma and response to therapy

Abstract

The utilisation of nocturnal wheeze monitoring and quantification for assessment of asthma activity was studied in symptomatic school-aged children before and during treatment.Twelve children 6-14 yrs of age with mild or moderate untreated asthma were studied at home three times: before, 48 h and 6 weeks into treatment with 5 mg montelukast daily. Lung sounds were recorded overnight by an automatic wheeze detection device (PulmoTrack1). Per cent wheezing within each respiratory cycle was calculated every 30 s throughout the night and a Nocturnal Wheeze Index (NWI) was calculated for the total night. The results were compared with spirometric indices (forced expiratory volume in one second (FEV1), forced vital capacity), bronchial reactivity (provocative concentration causing a 20% fall in FEV1 by adenosine 59-monophosphate (PC20)) and daily symptom scores, performed in parallel at each stage of the study.The pretreatment NWI was 814¡898 (mean¡SD), which declined to 318¡199 2 days after onset, and to 137¡101 after 6 weeks of treatment. The NWI in seven healthy children was 47¡43. The FEV1, PC20 and symptom scores improved in parallel.Wheeze monitoring provides quantitative and noninvasive information about the extent of nocturnal wheezing in children, correlates well with conventional indices of asthma activity and can assist in assessing efficacy of treatment. Eur Respir J 2003; 21: 621-626.

Automatic prediction of spirometry readings from cough and wheeze for monitoring of asthma severity

“…Akram et al [3] proposed a segmentation scheme of respiratory sounds for the detection of wheezes for asthma detection. Study carried out by Bentur et al [4] shows how wheeze monitoring provides quantative information that correlates well with asthma activity of children. On the other hand, several algorithms have been proposed to identify coughs [13], [16] for asthma detection.…”

Computerized Adventitious Respiratory Sounds as Outcome Measures for Respiratory Therapy: A Systematic Review

“…24,29 A strong association between the proportion of the respiratory cycle occupied by WHs and the degree of bronchial obstruction has been widely demonstrated. [21][22][23]35 This WH parameter, even when identified with standard auscultation, has shown to be sensitive to assess the effectiveness of respiratory interventions in children. 36,37 The WH complexity may also be a variable of interest as the presence of polyphonic WHs indicates a more serious obstruction than monophonic WHs 25 ; however, this was explored in only one study (ESs 0.24 -0.54).…”

“…The recording devices used varied among studies, as follows: microphones 21,24,25,27,29 ; piezoelectric sensors 20,22,23,26,30 ; and electronic stethoscopes. 5,28 Algorithms based on fast Fourier transformation were the most used to automatically detect ARSs.…”

“…The majority of the included studies were quasi-experimental, 5,[20][21][22][23][24][25] 3 studies were observational, [26][27][28] and 2 studies were randomized controlled trials (Table 2). 29,30 Ten studies recruited patients receiving specialized care, and 2 studies recruited patients during hospital admission.…”

“…Eight studies were conducted with adults (n ϭ 167; 60.7%; age range 21-73 years) 5,21,24-29 and 4 with children (n ϭ 108 [39.3%]; age range 4 months-18 y). 20,22,23,30 The interventions in most studies consisted of pharmacotherapy [20][21][22][23][24][25][26][27][28][29][30] ; only 2 studies combined pharmacotherapy with respiratory physical therapy. 5,29 The respiratory physical therapy consisted mainly of an active cycle of breathing techniques, 5,29 but also breathing retraining techniques (incentive spirometry, thoracic mobility, expansion and flexibility exercises, and aerobic training).…”