Chest
Volume 96, Issue 1, July 1989, Pages 46-53
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Differences in Acoustic and Dynamic Characteristics of Spontaneous Cough in Pulmonary Diseases

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The aim of this study was to determine whether the flow dynamics and sound spectra of spontaneous cough show characteristic differences in asthma, acute and chronic bronchitis, TBCS and FPD. During the cough, the air flow from the mouth and the sound from the sternal manubrium were simultaneously recorded. The cough sounds were analyzed spectrographically. Peak expiratory flow during cough was significantly lower in asthma than in TBCS, acute bronchitis or FPD. Duration of the first cough sound was longer in asthma than in FPD, TBCS or chronic bronchitis. The number of additional cough sounds was smaller in asthma than in the other conditions. The highest frequency components of cough sound were lower in asthma than in chronic bronchitis or TBCS. The results indicate that pulmonary diseases differ with respect to acoustic and dynamic characteristics of spontaneous cough. This finding may prove useful in the diagnosis of cough.

Section snippets

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 TBCS and seven of whom had FPD. Their mean age (±SD) was 53 ± 11 years (range, 24 to 68 years). Twenty-four were women. Anthropometric and pulmonary function data of the patients grouped according to diagnosis are presented in Table 1.9 None of the patients was taking any antitussives or medicine, which could induce cough, but some

Results

An average of 12.4 ± 6.2 (mean ± SD) coughs (range, 4 to 27) were recorded from each patient. Typically, a cough reflex comprised deep inspiration followed by glottic closure, glottic opening and rapid expiratory flow (CPEF) (Fig 2). However, one cough could include several opening and closing phases without intermittent inspirations. The sounds always occurred simultaneously with the CPEF phases. The numeric data from phonopneumographic measurements are presented in Table 2 and those from the

Discussion

The groups for the present study were selected with the purpose of studying patients with different pathophysiologic basis of cough: asthma with variable bronchial obstruction, bronchitis with expectoration or infection or both, TBCS with pathologic bronchial dynamics, and FPD with reorganization of the pulmonary tissue. Since the patients were breathing through a mouthpiece, we recorded the cough sounds at the sternal manubrium. With the microphone on the cheek, the mouthpiece and noseclip

ACKNOWLEDGMENTS

The authors wish to thank Professor Markku Rahiala, D.Pol.Sc., from the Department of Statistical Sciences, Helsinki University, for his help in the statistical analyses; Mr. Reijo Aulanko, M.Sc., from the Department of Phonetics, Helsinki University, for advising sound spectral analyses; and Mr. Hannu Seitsonen, Civil Engineer, from Helsinki University Central Hospital, for guidance in solving technical problems.

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  • Cited by (0)

    This study was supported by the Finnish Association Against Tuberculosis (Dr. Piirilä) and the Sigrid Juselius Foundation (Dr. Sovijärvi).

    Manuscript received July 11; revision accepted November 3.

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