Pediatr Allergy Respir Dis.  2012 Dec;22(4):344-353.

Validity of Cough-Holter Monitoring for the Objective Assessment of Cough and Wheezing in Children with Respiratory Symptoms

Affiliations
  • 1Department of Pediatrics, Korea University College of Medicine, Seoul, Korea. yoolina@korea.ac.kr
  • 2Department of Pediatrics, Hanil General Hospital, Seoul, Korea.
  • 3Environmental Health Center for Childhood Asthma, Korea University Anam Hospital, Seoul, Korea.
  • 4Department of Pediatrics, Mokpo Hansarang Hospital, Mokpo, Korea.

Abstract

PURPOSE
Cough and wheezing are the most common respiratory symptoms in children. Recently, the cough-holter monitoring has been used to estimate the frequency and intensity of cough and wheezing, objectively. In this study, we aimed to evaluate the validity of cough-holter monitoring for the objective assessment of cough and wheezing in the hospitalized children with respiratory symptoms.
METHODS
Cough-holter monitoring was performed in 59 children who suffered from cough and/or wheezing. We obtained the information on the frequency and intensity of cough and wheezing from the parents, a pediatrician, and cough-holter monitoring. Visual Analogue Scale (VAS) scores were taken by parents, and the pediatrician estimated the wheezing score by using a stethoscope. We assessed a relationship between the VAS scores, wheezing score, and cough-holter monitoring data.
RESULTS
The frequencies and intensities of cough correlated positively with the VAS scores (r=0.301, P=0.032; and r=0.540, P=0.001, respectively) and the frequencies and intensities of wheezing also correlated positively with the Wheezing scores. (r=0.335, P=0.011; and r=0.457, P=0.001, respectively) The wheezing intensity did not correlate with the Wheezing score in wheezing children. (r=0.321, P=0.089)
CONCLUSION
Cough-holter monitoring correlated positively with the VAS scores and the wheezing scores. Cough-holter monitoring appears to be a useful objective assessment tool for the children who have suffered from cough and/or wheezing.

Keyword

Children; Cough; Cough-holter; VAS score; Wheezing

MeSH Terms

Child
Child, Hospitalized
Cough
Humans
Parents
Respiratory Sounds
Stethoscopes

Figure

  • Fig. 1 Correlations between Visual Analogue Scale (VAS) scores and cough event counts (CEC) (A) and the highest cough component counts per cough event count (CCC/CEC [H]) (B) in total subjects (n=59).

  • Fig. 2 Correlations between Visual Analogue Scale (VAS) scores and cough event counts (CEC) (A) and the highest cough component counts per cough event count (CCC/CEC [H]) (B) in wheezing subjects.

  • Fig. 3 Correlations between Visual Analogue Scale (VAS) scores and cough event counts (CEC) (A) and the highest cough component counts per cough event count (CCC/CEC [H]) (B) in nonwheezing subjects.

  • Fig. 4 Correlations between wheezing scores and number of segment with wheezing (WZ [TR, N]) (A) and the highest total wheezing% (WZ [TR, H]) (B) in total subjects.

  • Fig. 5 Correlations between wheezing scores and number of segment with wheezing (WZ [TR, N]) (A) and the highest total wheezing% (WZ [TR, H]) (B) in wheezing subjects.


Reference

1. Ilangovan P, Pedersen S, Godfrey S, Nikander K, Noviski N, Warner JO. Treatment of severe steroid dependent preschool asthma with nebulised budesonide suspension. Arch Dis Child. 1993. 68:356–359.
Article
2. Lowell DI, Lister G, Von Koss H, McCarthy P. Wheezing in infants: the response to epinephrine. Pediatrics. 1987. 79:939–945.
Article
3. Schultz A, Brand PL. Episodic viral wheeze and multiple trigger wheeze in preschool children: a useful distinction for clinicians? Paediatr Respir Rev. 2011. 12:160–164.
Article
4. Hsu JY, Stone RA, Logan-Sinclair RB, Worsdell M, Busst CM, Chung KF. Coughing frequency in patients with persistent cough: assessment using a 24 hour ambulatory recorder. Eur Respir J. 1994. 7:1246–1253.
Article
5. Archer LN, Simpson H. Night cough counts and diary card scores in asthma. Arch Dis Child. 1985. 60:473–474.
Article
6. Taylor JA, Novack AH, Almquist JR, Rogers JE. Efficacy of cough suppressants in children. J Pediatr. 1993. 122(5 Pt 1):799–802.
Article
7. Chang AB, Newman RG, Carlin JB, Phelan PD, Robertson CF. Subjective scoring of cough in children: parent-completed vs child-completed diary cards vs an objective method. Eur Respir J. 1998. 11:462–466.
Article
8. Chang AB, Phelan PD, Robertson CF, Roberts RG, Sawyer SM. Relation between measurements of cough severity. Arch Dis Child. 2003. 88:57–60.
Article
9. Faruqi S, Thompson R, Wright C, Sheedy W, Morice AH. Quantifying chronic cough: objective versus subjective measurements. Respirology. 2011. 16:314–320.
Article
10. Decalmer SC, Webster D, Kelsall AA, McGuinness K, Woodcock AA, Smith JA. Chronic cough: how do cough reflex sensitivity and subjective assessments correlate with objective cough counts during ambulatory monitoring? Thorax. 2007. 62:329–334.
Article
11. Bentur L, Beck R, Shinawi M, Naveh T, Gavriely N. Wheeze monitoring in children for assessment of nocturnal asthma and response to therapy. Eur Respir J. 2003. 21:621–626.
Article
12. Levy ML, Godfrey S, Irving CS, Sheikh A, Hanekom W, Bush A, et al. Wheeze detection: recordings vs. assessment of physician and parent. J Asthma. 2004. 41:845–853.
Article
13. van Essen-Zandvliet EE, Hughes MD, Waalkens HJ, Duiverman EJ, Kerrebijn KF. Dutch CNSLD Study Group. Remission of childhood asthma after long-term treatment with an inhaled corticosteroid (budesonide): can it be achieved? Eur Respir J. 1994. 7:63–68.
Article
14. König P, Eigen H, Ellis MH, Ellis E, Blake K, Geller D, et al. The effect of nedocromil sodium on childhood asthma during the viral season. Am J Respir Crit Care Med. 1995. 152(6 Pt 1):1879–1886.
Article
15. Cane RS, Ranganathan SC, McKenzie SA. What do parents of wheezy children understand by "wheeze"? Arch Dis Child. 2000. 82:327–332.
Article
16. Lee H, Arroyo A, Rosenfeld W. Parents' evaluations of wheezing in their children with asthma. Chest. 1996. 109:91–93.
Article
17. Cane RS, McKenzie SA. Parents' interpretation of children's respiratory symptoms on video. Arch Dis Child. 2001. 84:31–34.
18. Keeley DJ, Silverman M. Issues at the interface between primary and secondary care in the management of common respiratory disease.2: Are we too ready to diagnose asthma in children? Thorax. 1999. 54:625–628.
Article
19. Barry SJ, Dane AD, Morice AH, Walmsley AD. The automatic recognition and counting of cough. Cough. 2006. 2:8.
Article
20. Coyle MA, Keenan DB, Henderson LS, Watkins ML, Haumann BK, Mayleben DW, et al. Evaluation of an ambulatory system for the quantification of cough frequency in patients with chronic obstructive pulmonary disease. Cough. 2005. 1:3.
Article
21. Birring SS, Matos S, Patel RB, Prudon B, Evans DH, Pavord ID. Cough frequency, cough sensitivity and health status in patients with chronic cough. Respir Med. 2006. 100:1105–1109.
Article
22. Smith JA, Owen EC, Jones AM, Dodd ME, Webb AK, Woodcock A. Objective measurement of cough during pulmonary exacerbations in adults with cystic fibrosis. Thorax. 2006. 61:425–429.
Article
23. Leconte S, Ferrant D, Dory V, Degryse J. Validated methods of cough assessment: a systematic review of the literature. Respiration. 2011. 81:161–174.
Article
24. Fredberg JJ, Inouye D, Miller B, Nathan M, Jafari S, Raboudi SH, et al. Airway smooth muscle, tidal stretches, and dynamically determined contractile states. Am J Respir Crit Care Med. 1997. 156:1752–1759.
Article
25. Raboudi SH, Miller B, Butler JP, Shore SA, Fredberg JJ. Dynamically determined contractile states of airway smooth muscle. Am J Respir Crit Care Med. 1998. 158(5 Pt 3):S176–S178.
Article
26. Deane S, Thomson A. Obesity and the pulmonologist. Arch Dis Child. 2006. 91:188–191.
Article
27. Story RE. Asthma and obesity in children. Curr Opin Pediatr. 2007. 19:680–684.
Article
28. Camargo CA Jr, Field AE, Colditz GA, Spiezer FE. Body mass index and asthma in children ages 9-14. Am J Respir Crit Care Med. 1999. 159:3 Suppl. A150.
29. Schwartz J, Gold D, Dockery DW, Weiss ST, Speizer FE. Predictors of asthma and persistent wheeze in a national sample of children in the United States. Association with social class, perinatal events, and race. Am Rev Respir Dis. 1990. 142:555–562.
Article
30. Luder E, Melnik TA, DiMaio M. Association of being overweight with greater asthma symptoms in inner city black and Hispanic children. J Pediatr. 1998. 132:699–703.
Article
31. Chang AB, Newman RG, Phelan PD, Robertson CF. A new use for an old Holter monitor: an ambulatory cough meter. Eur Respir J. 1997. 10:1637–1639.
Article
32. Koehler U, Gross V, Reinke C, Penzel T, Vogelmeier CF. Acoustic analysis of nocturnal bronchial obstruction. Pneumologie. 2002. 56:19–24.
33. Koehler U, Gross V, Koch S, Reinke C, Penzel T, Becker H, et al. Nocturnal long-term recording of breath sounds in patients with bronchial asthma: a reasonable diagnostic option? Pneumologie. 2005. 59:872–878.
Article
Full Text Links
  • PARD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr