Lung Sounds in Children before and after Respiratory Physical Therapy for Right Middle Lobe Atelectasis.
BACKGROUND
Chest auscultation is commonly performed during respiratory physical therapy (RPT). However, the changes in breath sounds in children with atelectasis have not been previously reported. The aim of this study was to clarify the characteristics of breath sounds in children with atelectasis using acoustic measurements.


METHODS
The subjects of this study were 13 children with right middle lobe atelectasis (3-7 years) and 14 healthy children (3-7 years). Lung sounds at the bilateral fifth intercostal spaces on the midclavicular line were recorded. The right-to-left ratio (R/L ratio) and the expiration to inspiration ratio (E/I ratio) of the breath sound sound pressure were calculated separately for three octave bands (100-200 Hz, 200-400 Hz, and 400-800 Hz). These data were then compared between the atelectasis and control groups. In addition, the same measurements were repeated after treatment, including RPT, in the atelectasis group.


RESULTS
Before treatment, the inspiratory R/L ratios for all the frequency bands were significantly lower in the atelectasis group than in the control group, and the E/I ratios for all the frequency bands were significantly higher in the atelectasis group than in the control group. After treatment, the inspiratory R/L ratios of the atelectasis group did not increase significantly, but the E/I ratios decreased for all the frequency bands and became similar to those of the control group.


CONCLUSIONS
Breath sound attenuation in the atelectatic area remained unchanged even after radiographical resolution, suggesting a continued decrease in local ventilation. On the other hand, the elevated E/I ratio for the atelectatic area was normalized after treatment. Therefore, the differences between inspiratory and expiration sound intensities may be an important marker of atelectatic improvement in children.
Department of Rehabilitation, National Hospital Organization, Fukuoka National Hospital, Fukuoka, Japan.
Satoshi
S
Adachi
Department of Pulmonology, National Hospital Organization, Fukuoka National Hospital, Fukuoka, Japan.
Hiroshi
H
Nakano
Department of Pediatrics, National Hospital Organization, Fukuoka National Hospital, Fukuoka, Japan.
Hiroshi
H
Odajima
Department of Pediatrics, National Hospital Organization, Fukuoka National Hospital, Fukuoka, Japan.
Chikako
C
Motomura
Department of Rehabilitation, National Hospital Organization, Fukuoka National Hospital, Fukuoka, Japan.
Yukiko
Y
Yoshioka
D001314:Auscultation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008168:Lung / Q000502:physiology*; D008297:Male; D026741:Physical Therapy Modalities; D001261:Pulmonary Atelectasis / Q000503:physiopathology* / Q000628:therapy*; D012135:Respiratory Sounds / Q000502:physiology*