RT Journal Article SR Electronic T1 Bronchial provocation testing (BPT) of pre-school children by acoustic respiratory monitoring (ARM) of wheeze (Wz) and cough (C) JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP p4275 VO 38 IS Suppl 55 A1 Galit Livnat A1 Claudia Katz A1 Moshe Rotschild A1 Yazeed Toukan A1 Lea Bentur YR 2011 UL http://erj.ersjournals.com/content/38/Suppl_55/p4275.abstract AB Background: Unequivocal diagnosis of asthma in pre-school children is limited by their inability to perform spirometry. We evaluated the feasibility of BPT using an automatic ARM system.Methods: We performed doubling-dose methacholine BPT in 41 children age 2 to 7 to confirm asthma. Provoking Concentration by wheeze-endpoint (PCWz) was declared when Wz was heard by physician auscultation, SpO2 fell by 5% or respiratory rate (RR) increased by >50%. ARM of Wz and C (PulmoTrackĀ®, KarmelSonix, Israel) was recorded in parallel and reviewed off-line.Results: Endpoint by ARM was the same as clinical PCWz in 25/41 (60.9%) and preceded PCWz in 8/41 (19.5%) patients by 1-4 doubling doses. In 4 patients (9.8%) PCWz preceded ARM endpoint and in 4 patients (9.8%) the test was inconclusive due to poor patient cooperation. Of the 4 tests where ARM lagged behind PCWz, 2 were due to ARM not detecting Wz and 2 were possibly stopped prematurely by the physician. In 6 of the patients there were false positive ARM Wz detections due to ambient noise. In 9/41 patients (22%) there was excessive cough towards the endpoint.Discussion and conclusions: ARM-based BPT was as good as or better than PCWz in 80% of tests. Improved sensitivity and specificity of wheeze detection and automatic detection of increased RR are needed to facilitate physician-unattended use of the ARM for a BPT.Acknowledgement: S Godfrey, N Gavriely and the KarmelSonix Technical Team assisted in data recording and analysis. M Meriach, RT, performed the BPTs.