Adventitious respiratory sounds in children with respiratory infection

• Autor(a) principal: Oliveira, Ana Luísa Araújo
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10773/13734
• topic: Fisioterapia; Doenças respiratórias - Crianças; Sinais acústicos

Background: Lower respiratory tract infections (LRTI) are the leading cause of hospital visits in children under 5 years old. Therefore, there is an urgent and unmet need to develop objective, reliable and quick measures for respiratory paediatric assessment. Computerised adventitious respiratory sounds (ARS) have shown to be objective and reliable to assess/monitor respiratory diseases; however its application in children with LRTI is unknown. Aim: To characterise/compare ARS in healthy children and children with LRTI. Methods: A cross-sectional descriptive-comparative study was conducted in three healthcare institutions. Children were diagnosed by the paediatrician as healthy or with a LRTI and grouped according to their age (i.e, 0-2 years old or 3-5 years old). Socio-demographic and anthropometric data, type and severity of LRTI and cardio-respiratory parameters were collected. Respiratory sounds were recorded from the chest with a digital stethoscope following the Computerised Respiratory Sound Analysis guidelines. Wheezes’ location, mean number, type, frequency and occupation rate and crackles’ location, mean number, type, frequency, initial deflection width, two cycle duration, and largest deflection width were analysed per breathing phase. Results: Forty children enrolled in this study: 22 aged 0-2 years old (G1: 11 healthy; G2: 11 with LRTI) and 18 aged 3-5 years old (G3: 9 healthy; G4: 9 with LRTI). Few children, both healthy and with LRTI presented wheezes. In both age ranges, children with LRTI presented a higher percentage of the expiratory phase occupied by wheezes (G1: M 2.15 IQR 1.45 vs. G2: M 4.73 IQR 6.72 p=0.001; G3: M 2.80 IQR 3.27 vs. G4: M 5.17 IQR 15.99 p=0.07). Crackles were found in all children in at least one chest location. In both age ranges, children with LRTI presented more inspiratory crackles (G1: M 0.25 IQR 0.31 vs. G2: M 0.52 IQR 0.70; p<0.001; G3: M 0.50 IQR 0.49 vs. G4: M 0.70 IQR 0.21 p=0.03), especially fine crackles than healthy children (G1: M 0.07 IQR 0.13 vs. G2: M 0.18 IQR 0.42 p=0.001; G3: M 0.11 IQR 0.21 vs. G4: M 0.17 IQR 0.23 p=0.001). Coarse expiratory crackles were the most common type of crackle found in both healthy children (G1: M 0.33 IQR 0.56; G3: M 0.56 IQR 0.99) and children with LRTI (G2: M 0.33 IQR 0.56; G4: M 1.14 IQR 1.38). No differences were found for the remaining parameters. Conclusion: Healthy children and children with LRTI of different ages present ARS (i.e., crackles and wheezes). The occupation rate of wheezes and the mean number of crackles were the parameters that most differed between healthy children and children with LRTI in both age ranges. Therefore these ARS’ parameters may be the best criteria to discriminate the groups.