The aim of this investigation was ...

The aim of this investigation was to determine whether the result dynamics and sound spectra of spontaneous cough present to view characteristic differences in asthma, acute and chronic bronchitis, TBC and FPD During the cough the air melt from the mouth and the hearty from the sternal manubrium were simultaneously recorded. The cough heartys were analyzed spectrographically. Peak expiratory pour during cough was significantly lower in asthma than in TBC acute bronchitis or FPD Duration of the first cough good was longer in asthma than in FPD TBC or chronic bronchitis. The number of additional cough entires was smaller in asthma than in the other conditions. The highest oftenness components of cough sound were lower in asthma than in chronic bronchitis or TBC The springs indicate that pulmonary diseases differ with revere to acoustic and dynamic characteristics of spontaneous cough This finding may make trial of useful in the diagnosis of cough

(Chest 1989; 96:46-53)

Cough is undivided of the most common symptoms of pulmonary disease. Its properties are not, however, clinically consistent from undivided disease to another. Few objective studies have been published forward the acoustic or dynamic patterns of cough; greatest in quantity studies deal with intensity analysis or tussiphonography of voluntary cough[12] single in kind study has analyzed the spectral peaces of cough sounds,[3] but works investigating simultaneously the liquefy dynamic and sound spectral characteristics of spontaneous cough are lacking.

Cough may be an early sign of asthma.[4,5] Phonographic studies have shown voluntary cough of patients with chronic bronchitis[1] and asthma[1,6] to differ from that of normal bodys The flow dynamics of cough also have been shown to vary with the disease.[2,6-8]

Our aim was to cogitation whether spontaneous cough in certain pulmonary diseases--namely asthma, acute and chronic bronchitis, FPD and TBCS--possesse typical acoustic or dynamic features.

Patients and Methods

Patients

We studied 31 patients with spontaneous cough seven of whom had asthma, five of whom had acute bronchitis, seven of whom had chronic bronchitis, five of whom had TBC and seven of whom had FPD Their mean age ([+ or -] SD) was 53 [+ or -] 11 years (range, 24 to 68 years). Twenty-four were women Anthropometric and pulmonary function data of the patients assign places toed according to diagnosis are at handed in Table 1.[9] None of the patients was taking any antitussives or medicine, which could induce cough further some were using bronchodilators. Inhaled bronchodilators were avoided 4 to 17 h (mean, 58 h) before the cough entire recordings.

The diagnosis of the seven patients with asthma was based onward the ATS criteria from 1986[10] These patients were admitted to the hospital because of exacerbation. Cough recordings were made three to seven days after arrival. At the time of recording, wheezing unhurts were heard on pulmonary auscultation. The voluntary peak expiratory sweep along was 319 [+ or -] 98 L/min (range, 200 to 482 L/min; 726 [+ or -] 122 percent of the predicted values[11]). All of these patients were receiving peroral steroids and theophyllamines, inhaled beta-sympathomimetics and ipratropium bromide. Four patients also were receiving inhaled doses of budesonide or beclomethasone. The chest x-ray film was normal in all excepting one patient who showed slight fibrotic changes. Bronchoscopic studies were not performed.

In the five patients with acute bronchitis, symptoms had lasted from single in kind to four weeks before the recording. common patient also had rheumatoid arthritis and another patient arterial hypertension. The findings of dynamic spirometry were normal in four patients moreover showed moderately diminished vital capacity in one[9] Bronchoscopic studies were not performed. The chest x-ray film was normal in three patients; single had an enlarged heart and single in kind slight fibrotic changes in the lungs

The diagnosis of the seven patients with chronic bronchitis was based upon the 1986 ATS criteria.[10] In all these patients cough was associated with abundant expectoration. Symptoms had lasted from 2 to 20 years. All had normal chest x-ray film findings. Bronchoscopy was performed in six of them; they all had typical bronchitic changes in bronchial walls and couple showed slight tracheobronchial collapse disposition Dynamic spirometry revealed normal ventilatory function in four patients, moderate obstruction in sum of two units and slight obstruction in one[9] single in kind patient was receiving salbutamol and three oxitropium bromide medication, the two of which were inhaled.

Bronchoscopy revealed marked collapse of the tracheobronchial tree[12-14] in five patients, justifying a diagnosis of TBC All of these patients had normal chest x-ray film and dynamic spirometry findings. The production of mucus was slight or negligible. Cough had lasted from four to ten years. All patients were receiving [TABULAR DATA OMITTED] symptomatic treatment: ipratropium bromide in five, theophyllamines in couple inhaled sodium chromoglycate in undivided and budesonide bromide in one