Time course of nocturnal cough and wheezing in children with acute bronchitis monitored by lung sound analysis

Eur J Pediatr. 2019 Sep;178(9):1385-1394. doi: 10.1007/s00431-019-03426-4. Epub 2019 Jul 18.

Abstract

Cough and wheezing are the predominant symptoms of acute bronchitis. Hitherto, the evaluation of respiratory symptoms was limited to subjective methods such as questionnaires. The main objective of this study was to objectively determine the time course of cough and wheezing in children with acute bronchitis. The impact of nocturnal cough on parent's quality of life was assessed as secondary outcome. In 36 children (2-8 years), the frequency of nocturnal cough and wheezing was recorded during three nights by automated lung sound monitoring. Additionally, parents completed symptom logs, i.e., the Bronchitis Severity Score (BSS), as well as the Parent-proxy Children's Acute Cough-specific Quality of Life Questionnaire (PAC-QoL). During the first night, patients had 34.4 ± 52.3 (mean ± SD) cough epochs, which were significantly reduced in night 5 (13.5 ± 26.5; p < 0.001) and night 9 (12.8 ± 28.1; p < 0.001). Twenty-two patients had concomitant wheezing, which declined within the observation period as well. All subjective parameters (BSS, Cough log and PAC-QoL) were found to be significantly correlated with the objectively assessed cough parameters.Conclusion: Long-term recording of cough and wheezing offers a useful opportunity to objectively evaluate the time course of respiratory symptoms in children with acute bronchitis. To assess putative effects of pharmacotherapy on nocturnal bronchitis symptoms, future studies in more homogeneous patient groups are needed. What is Known: • Cough and wheezing are the predominant symptoms of acute bronchitis. • There is a diagnostic gap in long-term assessment of these respiratory symptoms, which needs to be closed to optimize individual therapies. What is New: • Long-term recording of nocturnal cough and wheezing allows for objective evaluation of respiratory symptoms in children with acute bronchitis and provides a tool to validate the efficacy of symptomatic bronchitis therapies.

Keywords: acoustic long-term recording; acute bronchitis; cough; time course; wheezing.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Acute Disease
  • Bronchitis / physiopathology*
  • Bronchitis / psychology
  • Child
  • Child, Preschool
  • Cough / diagnosis
  • Cough / etiology
  • Cough / physiopathology*
  • Cough / psychology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Monitoring, Physiologic
  • Parents / psychology
  • Patient Acceptance of Health Care
  • Quality of Life
  • Respiratory Sounds / diagnosis
  • Respiratory Sounds / physiopathology*
  • Severity of Illness Index
  • Time Factors