Adenosine Bronchial Provocation With Computerized Wheeze Detection in Young Infants With Prolonged Cough

Bentur, Lea; Beck, Raphael; Berkowitz, Drora; Hasanin, Jamal; Berger, I; Elias, Nael; Gavriely, Noam

doi:10.1378/chest.126.4.1060

Cited by 32 publications

(27 citation statements)

References 17 publications

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“…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).…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…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).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…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.…”

Section: Studies Included In Review 12mentioning

confidence: 99%

“…The presence of WHs was used to identify a bronchial response during bronchial provocation tests in 2 studies conducted with children. 20,22 Sanchez et al 20 used concentrations of methacholine, and found that WHs had 50% sensitivity and 100% specificity to detect bronchial hyper-reactivity. Bentur et al 22 observed that WHs were detected at a mean adenosine concentration of 15.6 mg/ mL.…”

Section: Whsmentioning

confidence: 99%

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

2013

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INTRODUCTION:There is a need to develop simple, noninvasive, and sensitive outcome measures for respiratory therapy. Adventitious respiratory sounds (ie, crackles and wheezes) can be objectively characterized with computerized respiratory sound analysis (CORSA) and have been shown to contribute for diagnosis purposes; however, their potential for use as outcome measures is unknown. Thus, this systematic review synthesizes the evidence on the use of computerized adventitious respiratory sounds as outcome measures. METHODS: The Web of Knowledge, MEDLINE, EMBASE, and SCOPUS databases were searched. Reviewers independently selected studies according to the eligibility criteria. Effect sizes and 95% CIs were computed. RESULTS: Twelve studies with different designs (observational, n ‫؍‬ 3; quasi-experimental n ‫؍‬ 7; and randomized controlled trial, n ‫؍‬ 2) were included. Eight studies were conducted with adults, and 4 studies with children. Most studies explored only one type of adventitious respiratory sound. For wheezes, the occupation rate seemed to be the most promising parameter to be used as an outcome measure, with high/medium effect sizes (0.62-1.82). For crackles, the largest deflection width showed high effect sizes (1.31 and 1.04); however, this was explored in only one study. Crackle number and 2-cycle duration presented conflicting information, with high/poor effect sizes depending on the study. CONCLUSIONS: Specific variables of each adventitious respiratory sound detected and characterized by CORSA showed high effect sizes and, thus, the potential to be used as outcome measures. Further research with robust study designs and larger samples (both of children and adult populations), and following CORSA guidelines is needed to build evidence-based knowledge on this topic.

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