Document Detail

Crackle Pitch and Rate Do Not Vary Significantly During a Single Examining Session in Patients with Pneumonia, Congestive Heart Failure, and Interstitial Pulmonary Fibrosis.
MedLine Citation:
PMID:  21333084     Owner:  NLM     Status:  Publisher    
BACKGROUND: The purpose of this study was to determine the variability of crackles during a single examining session as assessed by a computerized lung sound analyzer (STG). METHODS: Using a 16-channel STG we examined the crackle pitch (CP) and crackle rate (CR) of 49 patients with pneumonia (PN), 52 with congestive heart failure (CHF), and 18 with pulmonary fibrosis (IPF). Patients were instructed to perform breathing maneuvers in the following sequence: normal breathing, deep breathing, cough several times followed by deep breathing, and a vital capacity maneuver (VCM), followed by a deep breathing maneuver. RESULTS: CP variability expressed as a percentage of the average CP was relatively small in all conditions and in all maneuvers: PN=11%; CHF=11%; IPF=7%. CR variability was also relatively small: PN=31%; CHF=32%; IPF=24%. Compared to the 1st deep breathing maneuver (100%), the average CP did not change significantly following coughing (PN=100%; CHF=103%; IPF=100%), the VCM (PN=100%; CHF=92%; IPF=104%), or during quiet breathing (PN=97%; CHF=100%; IPF=104%). Similarly, the average CR did not change significantly following coughing (PN=105%; CHF=110%; IPF=90%) or the VCM (PN=102%; CHF=101%; IPF=99%). However during normal breathing the CR was significantly lower in PN (74%, p<0.0001) and significantly higher in IPF (147%, p<0.05 ) than it was during deep breathing. In patients with CHF, the average CR during the normal breathing was not significantly different from the CRduring the 1st deep breathing maneuver (108%). CONCLUSION: Crackles in all three conditions were surprisingly stable. Neither CP nor CR changed significantly from breath to breath or from one deep breathing maneuver to another even when these maneuvers were separated by the cough and the VCM. CLINICAL IMPLICATIONS: The observation that CR is a relatively reproducible measurement during one examination provides evidence that it can be used to follow the course of cardiopulmonary illnesses such as PN, IPF, and CHF.
Andrey Vyshedskiy; Sadamu Ishikawa; Raymond Murphy
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-11
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  0020-1324     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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