Is clinical wheezing reliable as the endpoint for bronchial challenges in preschool children?

  title={Is clinical wheezing reliable as the endpoint for bronchial challenges in preschool children?},
  author={Simon Godfrey and Kamal Uwyyed and Chaim Springer and Avraham Avital},
  journal={Pediatric Pulmonology},
The present study was designed to compare the clinical finding of wheeze by auscultation with an objective evaluation by acoustic means at the endpoint of a bronchial challenge in preschool children. Challenges were undertaken using a tidal breathing method in 51 preschool children as part of the investigation of possible asthma. An electronic stethoscope was used for auscultation of each lung and for the simultaneous recording of the acoustic sonogram for analysis. In 24 children, the… 

Timing and nature of wheezing at the endpoint of a bronchial challenge in preschool children

Recording breath sounds continuously during tidal breathing inhalation challenges with adenosine 5′‐monophosphate adds safety to the technique by enabling the challenge to be stopped earlier, while the lack of a need to document the phase of breathing simplifies the technique.

The use of bronchial challenge to diagnose asthma in preschool children.

  • S. Godfrey
  • Medicine
    Primary care respiratory journal : journal of the General Practice Airways Group
  • 2009
An approach to the diagnosis of asthma in preschool children by means of an inhalation bronchial challenge, where the child is exposed to increasing doses of challenge agent until wheezing is detected at a dose below that at which normal subjects respond, thus indicating bronchia hyperreactivity.

A wheeze recognition algorithm for practical implementation in children

The wheeze recognition algorithm could identify wheezes in sound files and therefore may be useful in the practical implementation of respiratory illness management at home using properly developed devices.

Wheeze detection as a measure of bronchial challenge in young children with cough‐variant asthma and with classic asthma

To compare the sensitivity of these two techniques as endpoints for methacholine challenge in young children with cough‐variant asthma (CVA) and with classic asthma (CA), and to investigate whether oxygen saturation levels at the presence of wheezing differ in these two groups.

Utility of cough response during hypertonic histamine challenge in diagnosing asthma.

Clinical Usefulness of Breath Sounds

This chapter focuses on lung sounds as they are reported by patients and as a sign noted on chest auscultation performed with the stethoscope.



Use of tracheal auscultation for the assessment of bronchial responsiveness in asthmatic children.

Changes in lung sounds correspond well with a 20% fall in FEV1 after methacholine challenge, and wheeze is an insensitive indicator for assessing bronchial responsiveness.

Acoustic vs. spirometric assessment of bronchial responsiveness to methacholine in children.

It is concluded that wheezing during MC in children strongly suggests airway hyperresponsiveness; however, wheeze detection cannot fully replace spirometry in bronchial provocation testing.

Efficacy and safety of methacholine bronchial challenge performed by auscultation in young asthmatic children.

It is concluded that the modified auscultation method is effective and safe, with wheeze appearing at the end point in the large majority of the children.

The measurement of methacholine responsiveness in 5 year old children: three methods compared.

The FOT was found to be unreliable and the auscultation method valueless and potentially dangerous, since marked falls in PtcO2 of up to 33% sometimes occurred in the absence of wheeze.

Wheezing and airflow obstruction during methacholine challenge in children with cystic fibrosis and in normal children.

To study wheeze as an indicator of bronchial responses during standardized methacholine challenge (MCH), we used computerized analysis of respiratory sounds in children with cystic fibrosis (CF) and

Bronchial provocation determined by breath sounds compared with lung function.

Bronchial provocation testing by listening for wheeze over the trachea is a safe technique, which correlates with objective measures of lung function in young children.

Chest surface mapping of lung sounds during methacholine challenge

Lung sounds were sensitive to changes in airway caliber, but were not specific indicators of bronchial hyperresponsiveness.

Adenosine, methacholine, and exercise challenges in children with asthma or paediatric chronic obstructive pulmonary disease.

Methacholine distinguishes both asthma and paediatric COPD from controls with a sensitivity of 82-92%, but does not distinguish between asthma and children with COPD; exercise and AMP distinguish asthma from controlsWith a sensitivity and specificity of 84-98% but they also distinguishes asthma from paediatric CopD with a sensitive and specificity level of 85-90%.