School of Health Sciences, University of Aveiro, Campus de Santiago, Aveiro, Portugal.
Respir Care. 2012 Sep;57(9):1468-75. doi: 10.4187/respcare.01625. Epub 2012 Feb 17.
There is an urgent need to develop new outcome measures for respiratory therapy, to evaluate its effectiveness. Adventitious sounds generated from the lungs (crackles and wheezes), can now be quantified and characterized objectively with computer technology. To our knowledge, this is the first reported study designed to assess any change in lung crackles before and after a single session of airway clearance therapy.
Twenty-three stable bronchiectasis patients were recruited from United Kingdom out-patient clinics and treated with a single session of airway clearance therapy, using the active cycle of breathing technique. Sound recordings were made before and after the session at 7 anatomical chest locations. Computerized lung sound analysis was used to measure crackle parameters: 2-cycle deflection width (2CD), and crackle number per breath cycle (nBC). Perceived breathlessness, lung function, and oxygen saturation data were also recorded.
Crackle mean 2CD and mean nBC increased post intervention. Sixteen participants (70%) showed a statistically significant difference in mean crackle 2CD before and after the session at ≥ 1 chest location. Thirteen (57%) participants had a difference between mean crackle 2CD before and after the intervention > 1 Smallest Real Difference (SRD, mean SRD = 2.23 ms) at ≥ 1 chest location. Differences in mean crackle nBC before and after the intervention did not exceed the SRD (mean SRD = 32 crackles per breath cycle) in any participant. Perceived breathlessness was significantly reduced post intervention; no significant changes were observed in either lung function or oxygen saturation.
Crackle duration (2CD) was found to change after a single session of airway clearance therapy, and shows promise as a new outcome measure for respiratory therapy interventions.
迫切需要开发新的呼吸治疗结果衡量标准，以评估其疗效。现在，肺部产生的附加音（爆裂声和喘鸣音）可以使用计算机技术进行定量和客观描述。据我们所知，这是第一项旨在评估单次气道清除治疗前后肺部爆裂声变化的研究。
从英国门诊招募了 23 名稳定的支气管扩张症患者，并使用主动呼吸循环技术对其进行单次气道清除治疗。在治疗前后，在 7 个解剖胸部位置进行声音记录。使用计算机化的肺部声音分析来测量爆裂声参数：2 个周期的挠度宽度（2CD）和每个呼吸周期的爆裂声数量（nBC）。还记录了呼吸困难感知、肺功能和血氧饱和度数据。
干预后，爆裂声的平均 2CD 和平均 nBC 增加。16 名参与者（70%）在至少 1 个胸部位置显示出治疗前后平均爆裂声 2CD 的统计学显著差异。13 名参与者（57%）在治疗前后的平均爆裂声 2CD 之间存在差异> 1 个最小实际差异（SRD，平均 SRD=2.23ms），在至少 1 个胸部位置。在任何参与者中，干预前后平均爆裂声 nBC 的差异均未超过 SRD（平均 SRD=32 个呼吸周期的爆裂声）。干预后呼吸困难感知显著降低；肺功能或血氧饱和度均未观察到显著变化。
单次气道清除治疗后，爆裂声持续时间（2CD）发生变化，有望成为呼吸治疗干预的新结果衡量标准。
