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Timing and nature of wheezing at the endpoint of a bronchial challenge in preschool children
Author(s) -
Godfrey Simon,
Cohen Shlomo,
Avital Avraham,
Springer Chaim
Publication year - 2005
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20178
Subject(s) - wheeze , medicine , auscultation , inhalation , respiratory sounds , clinical endpoint , pediatrics , breathing , audiology , ventilation (architecture) , anesthesia , asthma , randomized controlled trial , mechanical engineering , engineering
Bronchial reactivity to inhaled agents in preschool children can be undertaken by auscultating the lungs to detect wheezing, but there is a lack of information on when wheeze first appears at the endpoint of the challenge and on the acoustic characteristics of the wheeze. We recorded breath sounds continuously during tidal breathing inhalation challenges with adenosine 5′‐monophosphate, using sensors attached over each upper lobe in 80 preschool children. In 35 children, the challenge was considered positive by a pediatrician who determined the endpoint by detecting wheeze on auscultation after an inhalation. Using acoustic analysis, we determined that the first wheeze appeared during the 2‐min period of nebulization in 31% of positive challenges; it was unilateral in 37%, and only inspiratory in 46%. A running window of 6 sec was used to detect at least two wheezes without reference to phase of breathing, and this index had a sensitivity of 97.6% and specificity of 99.7% for determining the endpoint of a challenge. Detecting wheeze acoustically adds safety to the technique by enabling the challenge to be stopped earlier, while the lack of a need to document the phase of breathing simplifies the technique. Pediatr Pulmonol. 2005; 39:262–267. © 2005 Wiley‐Liss, Inc.