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Lung sounds successful in determining effects of inhaled corticosteroids in infants, children
The effects of inhaled corticosteroid use can be effectively measured through the use of lung sound analysis — with an index of the chest wall at 700 Hz and sound intensity at 700 Hz — according to a study published in Respirology.
Additionally, this technique can be used to effectively foresee potential exacerbations and to identify children who have asymptomatic asthma.
“Peak expiratory flow monitoring and lung function tests are technically challenging in small children and infants,” Chizu Habukawa, MD, from the department of pediatrics at Minami Wakayama Medical Center, Tanabe, and colleagues wrote. “Lung sound analysis is a noninvasive method that does not require the cooperation of infants. Recent developments in signal processing methods have improved the extraction of physiologically and clinically relevant information from lung sounds.”
To assess the effect of inhaled corticosteroids in children with asthma, the researchers used a newly created technology that uses an index of the chest wall at 700 Hz and sound intensity at 700 Hz (ic700) to examine the children’s lung sounds. Lung sounds were collected from 70 children and infants in an asymptomatic state. All sounds were collected before use of inhaled corticosteroids and after use at 1, 2, 4, 6 and 8 weeks. At 10 weeks, Habukawa and colleagues assessed asthma control.
The scores collected through ic700 at 4, 6 and 8 weeks were evaluated against the presence of an attack in the following 2 weeks. The 70 children and infants were then placed in uncontrolled and well-controlled groups by the researchers.
After 8 weeks of inhaled corticosteroid treatment, the average ic700 scores of all children were significantly lessened, with those in the uncontrolled group having significantly higher scores at 4, 6 and 8 weeks after starting inhaled corticosteroids. The cut-off value for predicting asthma attacks for 2 weeks after evaluation was 0.0, with the area under the curve was labeled as 0.92 ± 0.04.
The sensitivity was measured at 83%, and the specificity was assessed at 88%. The negative predictive values were then measured at 84%. The results observed by the researchers were similar at both 4 and 8 weeks.
“Several problems remain for long-term asthma management in small children, including infants,” Habukawa and colleagues wrote. “There is a clear need for a new noninvasive method with which to evaluate the effects of inhaled corticosteroid treatment and to predict attack in the long-term management of asthmatic small children.” – by Katherine Bortz
Disclosure: This project was supported by Panasonic Corporation. Habukawa, Murakami and Nagasaka received a research grant from Panasonic Corporation.
