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Nikolaizik W, Wuensch L, Bauck M, Gross V, Sohrabi K, Weissflog A, Hildebrandt O, Koehler U, Weber S. Pilot study on nocturnal monitoring of crackles in children with pneumonia. ERJ Open Res 2021; 7:00284-2021. [PMID: 34853781 PMCID: PMC8628192 DOI: 10.1183/23120541.00284-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The clinical diagnosis of pneumonia is usually based on crackles at auscultation, but it is not yet clear what kind of crackles are the characteristic features of pneumonia in children. Lung sound monitoring can be used as a "longtime stethoscope". Therefore, it was the aim of this pilot study to use a lung sound monitor system to detect crackles and to differentiate between fine and coarse crackles in children with acute pneumonia. The change of crackles during the course of the disease shall be investigated in a follow-up study. PATIENTS AND METHODS Crackles were recorded overnight from 22:00 to 06:00 h in 30 children with radiographically confirmed pneumonia. The data for a total of 28 800 recorded 30-s epochs were audiovisually analysed for fine and coarse crackles. RESULTS Fine crackles and coarse crackles were recognised in every patient with pneumonia, but the number of epochs with and without crackles varied widely among the different patients: fine crackles were detected in 40±22% (mean±sd), coarse crackles in 76±20%. The predominant localisation of crackles as recorded during overnight monitoring was in accordance with the radiographic infiltrates and the classical auscultation in most patients. The distribution of crackles was fairly equal throughout the night. However, there were time periods without any crackle in the single patients so that the diagnosis of pneumonia might be missed at sporadic auscultation. CONCLUSION Nocturnal monitoring can be beneficial to reliably detect fine and coarse crackles in children with pneumonia.
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Affiliation(s)
- Wilfried Nikolaizik
- Dept of Pediatric Pulmonology, Children's Hospital, Philipps-University, Marburg, Germany
| | - Lisa Wuensch
- Dept of Pediatric Pulmonology, Children's Hospital, Philipps-University, Marburg, Germany
| | - Monika Bauck
- Dept of Pediatric Pulmonology, Children's Hospital, Philipps-University, Marburg, Germany
| | - Volker Gross
- Faculty of Health Sciences, University of Applied Sciences, Giessen, Germany
| | - Keywan Sohrabi
- Faculty of Health Sciences, University of Applied Sciences, Giessen, Germany
| | | | - Olaf Hildebrandt
- Division of Respiratory and Critical Care Medicine, Philipps-University, Marburg, Germany
| | - Ulrich Koehler
- Division of Respiratory and Critical Care Medicine, Philipps-University, Marburg, Germany
| | - Stefanie Weber
- Dept of Pediatric Pulmonology, Children's Hospital, Philipps-University, Marburg, Germany
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Lindenhofer M, Roth L, Mädel C, Götzinger F, Kainz K, Lex C, Frischer T, Reinweber M, Zacharasiewicz A. Wheeze and cough measurements at night in children with respiratory symptoms. BMC Pediatr 2020; 20:556. [PMID: 33308199 PMCID: PMC7733140 DOI: 10.1186/s12887-020-02455-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/01/2020] [Indexed: 02/06/2023] Open
Abstract
Background Nocturnal cough and wheeze are important symptoms when diagnosing any respiratory disease in a child, but objective measurements of these symptoms are not performed. Methods The aim of our study was to analyze the use of an automated detection system to assess breath sounds objectively in comparison to cough and wheeze questionnaires and to evaluate its feasibility in clinical practice. Results Forty-nine recordings of thirty-nine children were processed (asthma n = 13; cystic fibrosis n = 2; pneumonia n = 5; suspicion of habit cough n = 7; prolonged, recurrent or chronic cough n = 13), and cough and asthma scores were compared to the objective nocturnal recordings. Time for audio-validation of recordings took between 2 and 40 min (mean: 14.22 min, (SD): 10.72). Accuracy of the automated measurement was higher for cough than for wheezing sounds. Nocturnal cough readings but not wheeze readings correlated with some of the corresponding scores. Conclusion To our knowledge this is the first study using a new device to assess nocturnal cough and obstructive breath sounds objectively in children with a wide variety of respiratory diseases. The assessment proved user friendly. We obtained additional information on nighttime symptoms, which would otherwise have remained obscure. Further studies to assess possible diagnostic and therapeutic benefits of this device are needed.
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Affiliation(s)
- Markus Lindenhofer
- Klinikum Favoriten, Wiener Gesundheitsverbund, Wien, Austria.,Wilhelminenspital, Klinikum Ottakring, Department of Pediatrics and Adolescent Medicine, Teaching Hospital of the University of Vienna, Montleartstrasse 37, 1160, Wien, Austria
| | - Lena Roth
- Wilhelminenspital, Klinikum Ottakring, Department of Pediatrics and Adolescent Medicine, Teaching Hospital of the University of Vienna, Montleartstrasse 37, 1160, Wien, Austria
| | - Clemens Mädel
- Wilhelminenspital, Klinikum Ottakring, Department of Pediatrics and Adolescent Medicine, Teaching Hospital of the University of Vienna, Montleartstrasse 37, 1160, Wien, Austria
| | - Florian Götzinger
- Wilhelminenspital, Klinikum Ottakring, Department of Pediatrics and Adolescent Medicine, Teaching Hospital of the University of Vienna, Montleartstrasse 37, 1160, Wien, Austria
| | - Katharina Kainz
- Wilhelminenspital, Klinikum Ottakring, Department of Pediatrics and Adolescent Medicine, Teaching Hospital of the University of Vienna, Montleartstrasse 37, 1160, Wien, Austria
| | - Christiane Lex
- Department for Pediatric Cardiology and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany
| | - Thomas Frischer
- Wilhelminenspital, Klinikum Ottakring, Department of Pediatrics and Adolescent Medicine, Teaching Hospital of the University of Vienna, Montleartstrasse 37, 1160, Wien, Austria.,Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | | | - Angela Zacharasiewicz
- Wilhelminenspital, Klinikum Ottakring, Department of Pediatrics and Adolescent Medicine, Teaching Hospital of the University of Vienna, Montleartstrasse 37, 1160, Wien, Austria.
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Berger M, Wollsching-Strobel M, Majorski D, Magnet FS, Windisch W, Schwarz SB. [Day/Night Variability of Coughing Events in Interstitial Lung Disease]. Pneumologie 2020; 75:337-343. [PMID: 33147638 DOI: 10.1055/a-1266-6408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Besides dyspnea a dry cough is one of the main symptoms in patients with pulmonary fibrosis. Little is known about the 24-hour-variability of this symptom. Moreover, it is unclear if other auscultation phenomena occur. METHODS A long-term auscultation for 24-hours was performed in patients with fibrotic lung diseases (LEOSound, Löwenstein Medical GmbH & Co. KG, Medical-Electronics, Bad Ems, Germany). Coughing and wheezing sounds were recorded. For the following analysis the 24-hour period was divided into two intervals of 12 hours each (daytime and nighttime). Events were registered in epochs (at least one event in 30 seconds). RESULTS 20 patients were included (6 with nonspecific interstitial pneumonia and 14 with idiopathic pulmonary fibrosis). On average 166 coughing epochs were recorded in a 24-hour-period (day/night 116/50; P < 0.001). Moreover, 203 wheezing epochs were registered (day/night 84/119; P = 0.273). Auscultation phenomena did not correlate with spirometric and bodyplethymographic data, nor with data of diffusion capacity. DISCUSSION The study is showing the clinical potential of long-term auscultation in patients with fibrotic lung diseases. Especially the findings concerning the coughing symptoms were remarkable. It could be shown that there was a decrease of coughing during nighttime in comparison to daytime. In contrast to this, wheezing sounds were increasing at nighttime. The clinical relevance of this finding is yet to be assessed. Finally, there was no correlation between the severity of the disease measured by functional diagnostics and the amount of coughing.
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Affiliation(s)
- M Berger
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
| | - M Wollsching-Strobel
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
| | - D Majorski
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
| | - F S Magnet
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
| | - W Windisch
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
| | - S B Schwarz
- Kliniken der Stadt Köln gGmbH, Abteilung für Pneumologie, Universität Witten/Herdecke, Fakultät für Gesundheit, Köln
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