Treatment evaluation using lung sound analysis in asthmatic children

• Published in: Respirology (Carlton, Vic.) Vic.), 2017-11, Vol.22 (8), p.1564-1569
• Main Authors: Habukawa, Chizu, Murakami, Katsumi, Endoh, Mitsuru, Horii, Noriaki, Nagasaka, Yukio
• Format: Article
• Language: English
• Subjects: 700 Hz; Administration, Inhalation; Adolescent; Airway management; Airway Obstruction - diagnosis; Airway Obstruction - drug therapy; Airway Obstruction - etiology; Anti-Asthmatic Agents - therapeutic use; Asthma; Asthma - complications; Asthma - diagnosis; Asthma - drug therapy; Chest; Child; Child, Preschool; Children; Corticosteroids; Female; Glucocorticoids - therapeutic use; Humans; Infant; Infants; inhaled corticosteroid; lung sound analysis; Lungs; Male; Respiratory diseases; Respiratory Sounds; Respiratory tract; Sensitivity and Specificity; Sound
• ISSN: 1323-7799; 1440-1843
• DOI: 10.1111/resp.13109

ABSTRACT Background and objective Non‐invasive assessment of treatment and prediction of attacks in asthmatic children do not yet exist. Lung sound analysis can non‐invasively evaluate airway obstruction. We used a recently developed technology for analysing lung sounds using ic700 (index of the chest wall at 700 Hz, sound intensity at 700 Hz) to evaluate response to inhaled corticosteroid (ICS) in asthmatic children. Method Seventy asthmatic children, including infants, underwent lung sound recording in the asymptomatic state prior to and 1, 2, 4, 6 and 8 weeks after ICS treatment, and asthma control was assessed at 10 weeks. The ic700 scores at 4, 6 and 8 weeks were compared with the presence of attack during the following 2 weeks. Subjects were divided into uncontrolled and well‐controlled groups. Results The mean ic700 scores of all subjects significantly reduced after 8 weeks of treatment. The mean scores of the uncontrolled group were significantly higher than those of the well‐controlled group at 4, 6 and 8 weeks after starting treatment. The ic700 cut‐off value for predicting asthma attacks within 2 weeks following the evaluation was set at 0.0. After 6 weeks of treatment, the area under the curve was 0.92 ± 0.04; the sensitivity, specificity and positive and negative predictive values were 83%, 88% and 88% and 84%, respectively. Similar results were observed at 4 and 8 weeks. Conclusion The ic700 score is useful in assessing the effects of ICS treatment, predicting attack symptoms and identifying asymptomatic asthmatic children at a high risk for asthma attack. We developed a new technology for analysing lung sounds using the ic700 (index of the chest wall at 700 Hz, sound intensity at 700 Hz). We assess the effects of inhaled corticosteroid (ICS) in childhood and infantile asthma in a non‐invasive manner and predict an attack while avoiding the influence of individual differences of airflow.