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Lung sound analysis for predicting recurrent wheezing in preschool children

Manabu Miyamoto¹, Shigemi Yoshihara¹, Hiromi Shioya²

¹Department of Pediatrics, Dokkyo Medical University, Mibu, Japan.

The Journal of Allergy and Clinical Immunology. Global

|January 23, 2024

Abstract

Background:

In young healthy children, assessing airflow limitation may be difficult because of narrowing of the airways, which is a pathology of asthma, and responsiveness to bronchodilators.

Objective:

We investigated whether lung sound analysis could predict the development of recurrent wheezing (RW), which is one of the signs of asthma.

Methods:

In healthy children aged 3 to 24 months, we recorded and analyzed lung sounds before and after inhalation of bronchodilators and conducted a questionnaire survey. The children were followed up and assessed for the development of RW at age 3 years.

Results:

Of the 62 patients analyzed, 19 (30.6%) developed RW. The parameters ratio of power and frequency at 50% of the highest frequency of the dB power spectrum (RPF₅₀) and ratio of power and frequency at 75% of the highest frequency of the dB power spectrum (RPF₇₅), calculated by lung sound analysis, were lower in the RW group, with odds ratios of 0.77 (95% CI = 0.61-0.98) and 0.81 (95% CI = 0.66-0.99), respectively. The rate of change of lung sound analysis parameters after bronchodilator inhalation did not differ among the participants as a group; however, in the subgroup of children with a history of atopic dermatitis, the fourth area under the curve (B₄) divided by the total area under the curve of 100 Hz to the highest frequency of the dB power spectrum (A_T) and difference between the values of the ratio of power and frequency at 50% of the highest frequency of the dB power spectrum (ΔRPF₅₀) were elevated in the RW group (P = .015 and P = .041, respectively). In the subgroup of children with total a IgE level greater than 20 kUA/L, the sensitivities and specificities for predicting the development of RW were 85.7% (95% CI = 48.7-99.3) and 68.8% (95% CI = 44.4-85.8), respectively, when the cutoff value of ΔRPF₅₀ was set at 10.5%.

Conclusion:

The method of lung sound analysis allows noninvasive assessment of the airway, including airway hypersensitivity, in young children and may predict the risk of development of RW.

Keywords:

Asthma airway hypersensitivity infant lung sound analysis risk factor

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