Analysis of Tracheal Sounds During Forced Exhalation in Asthma Patients and Normal Subjects

Fiz, J.A.; Jané, Raimon; Salvatella, David; Izquierdo, José Luis; Lores, Luis; Caminal, P.; Morera, J.

doi:10.1378/chest.116.3.633

Cited by 34 publications

(24 citation statements)

References 12 publications

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“…The microphone was attached directly to the patient’s skin at the level of the cricoid cartilage using an elastic band [6]. At the same time, the airflow from a Jaeger pneumotachograph (Screenmate, Jaeger, Höchberg, Germany) was recorded at the mouth.…”

Section: Methodsmentioning

confidence: 99%

Analysis of Forced Wheezes in Asthma Patients

Fiz

Jané²,

Izquierdo

et al. 2006

Respiration

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Background: Spirometric parameters can be normal in many stable asthma patients, making a diagnosis difficult at certain times in the course of disease. Objectives: The present study aims to find differences and similarities in the acoustic characteristics of forced wheezes among asthma patients with and without normal spirometric values. Methods: Eleven chronic asthma patients (8 men/3 women) with moderate-to-severe airway obstruction (FEV₁ 48.4%), 9 stable asthma patients (6 males/3females) with normal spirometry (FEV₁ 84.0%) and a positive methacholine test and 14 healthy subjects (8/6) were enrolled in the study. A contact sensor was placed on the trachea, and wheezes were detected by a modified Shabtai-Musih algorithm in a time-frequency representation. Results: More wheezes were recorded in obstructive asthma patients than in stable asthma and control subjects: nonstable asthma 13.6 (13.3), stable asthma 3.5 (3.0) and control subjects 2.5 (2.1). The mean frequency of all wheezes detected was higher in control subjects than in either stable or non-stable asthma patients. The change in the total number of wheezes after terbutaline inhalation was more pronounced in nonstable asthma patients than in stable asthmatics and control subjects. Conclusions: This study confirms that wheeze recording during forced expiratory maneuvers can be a complementary measure to spirometry to identify asthma patients.

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Section: Methodsmentioning

confidence: 99%

Analysis of Forced Wheezes in Asthma Patients

Fiz

Jané²,

Izquierdo

et al. 2006

Respiration

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“…Administration of bronchodilators improves respiratory function and reduces tracheal sound spectral power [13]. With respect to the sounds heard on auscultation, the amplitude is proportional to the square of the flow rate, and the tracheal sound power is proportional to the fourth power of the flow rate [14,15].…”

Section: Discussionmentioning

confidence: 99%

Lung Sound Analysis Is Useful for Monitoring Therapy in Patients With Bronchial Asthma

Shimoda¹,

Obase²,

Nagasaka³

et al. 2017

J Investig Allergol Clin Immunol

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Background: Lung sound analysis (LSA) has been reported to be useful for predicting airway obstruction and inflammation in patients with bronchial asthma. Objectives: We examined whether the exhalation-to-inhalation sound pressure ratio in the middle frequency range (200-400 Hz) (E/I MF) is useful for monitoring therapy in patients with asthma. Methods: The study population comprised 84 patients with mild to moderate asthma whose LSA data were available before and after 1 year of daily treatment with (budesonide 800 μg). We analyzed whether the E/I MF before and after treatment was associated with the fractional exhaled nitric oxide (FeNO) level, sputum eosinophil percentage, respiratory function, and airway hyperresponsiveness. Results: Prior to treatment with budesonide, the E/I MF was significantly correlated with respiratory function, airway hyperresponsiveness, FeNO, and sputum eosinophil percentage. The cutoff values for the E/I MF to detect the abnormalities of respiratory function, FeNO, and sputum eosinophil percentage were 0.367, 0.358, and 0.363, respectively. With respect to the reference value, the E/I MF improved significantly in patients whose respiratory function and FeNO benefited from therapy with budesonide compared with patients whose respiratory function did not benefit from budesonide (odds ratios of 6.39 and 4.78, respectively). According to the multivariate analysis, patients whose E/I MF did not improve had a longer history of smoking (P=.038), poorer posttreatment respiratory function (P=.028), and higher posttreatment FeNO (P=.0095). Conclusion: Similar to respiratory function and FeNO, E/I MF based on LSA is a useful indicator for monitoring the efficacy of therapy in asthmatic patients.

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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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Analysis of Tracheal Sounds During Forced Exhalation in Asthma Patients and Normal Subjects

Cited by 34 publications

References 12 publications

Analysis of Forced Wheezes in Asthma Patients

Analysis of Forced Wheezes in Asthma Patients

Lung Sound Analysis Is Useful for Monitoring Therapy in Patients With Bronchial Asthma

Are Crackles an Appropriate Outcome Measure for Airway Clearance Therapy?

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