Báo cáo y học: Simultaneous versus video counting of coughs in hypertonic cough challenges

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Simultaneous versus video counting of coughs in hypertonic cough challenges...
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Báo cáo y học: " Simultaneous versus video counting of coughs in hypertonic cough challenges"Cough BioMed Central Open AccessResearchSimultaneous versus video counting of coughs in hypertonic coughchallengesHeikki O Koskela*, Minna K Purokivi and Raija M TukiainenAddress: Department of Respiratory Medicine, Kuopio University Hospital, P. O. Box 1777, 70211 Kuopio, FinlandEmail: Heikki O Koskela* - heikki.koskela@kuh.fi; Minna K Purokivi - minna.purokivi@kuh.fi; Raija M Tukiainen - raija.tukiainen@kuh.fi* Corresponding authorPublished: 9 September 2008 Received: 3 June 2008 Accepted: 9 September 2008Cough 2008, 4:8 doi:10.1186/1745-9974-4-8This article is available from: http://www.coughjournal.com/content/4/1/8© 2008 Koskela et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: The coughs occurring during cough provocation tests are usually counted at the same time when the test is being conducted, i.e., simultaneously. It is unknown whether cough counting from video recording might increase the accuracy of the cough counting. During recent years, cough challenges with hypertonic aerosols have been introduced. They often provoke very frequent coughing which may complicate the simultaneous cough counting. Objective: To assess whether cough counting from video recording is superior to simultaneous cough counting in two different hypertonic cough challenges. Methods: The analysis includes 82 hypertonic saline challenges performed on 66 subjects, providing 1984 observation minutes with both simultaneous and video cough counting. The cough sensitivity was expressed as the osmolality to provoke 15 cumulative coughs (CUM15). The analysis also includes 136 hypertonic histamine challenges performed on 114 subjects providing 5373 observation minutes with both simultaneous and video counting. The cough sensitivity was expressed as the cumulative number of coughs divided by the final histamine concentration administered (CCR). This challenge involved several additional measurements to cough counting. Results: For the saline challenge, the mean difference between the counting types was 0.0 coughs per minute with 95% limits of agreement of -1.2 to 1.2 coughs per minute. For the hypertonic histamine challenge the respective figures were 0.3 (-1.9 to 2.5) coughs per minute. At high coughing frequency the video counts tended to outnumber the simultaneous counts. The counting type had no effect on the hypertonic saline CUM15 and only a marginal effect on its repeatability. On the contrary, video counting resulted to significantly higher hypertonic histamine CCR values than simultaneous counting (p < 0.001). Conclusion: The agreement between simultaneous and video counting of coughs is generally good. However, as the coughing frequency increases, simultaneous counting may miss coughs, especially if the nurse has to share his/her attention to several activities simultaneously. Video recording is advisable for the hypertonic histamine challenge but unnecessary for the hypertonic saline challenge. To ensure reliable simultaneous cough counting, cough provocation tests should be performed in a quiet environment, applying as little unnecessary equipment and measurements as possible. Page 1 of 6 (page number not for citation purposes)Cough 2008, 4:8 http://www.coughjournal.com/content/4/1/8 The study utilising hypertonic histamine challenge [6]BackgroundCough provocation tests are mainly used for research pur- included 25 healthy subjects, 30 asthmatic patients, andposes with capsaicin and citric acid being the most com- 82 non-asthmatic patients with respiratory symptoms.monly used tussigens. The coughs are usually counted by There were 57 men and 80 women, mean 46 (12) years.a technician during the challenge and the test is stopped The Finnish National Agency of Medicines and the Insti-when a pre-determined number of coughs have been pro- tutional Ethics Committee approved the studies and allvoked. Usually a small number of coughs is required, subjects provided their informed written consent.from two to five coughs [1]. The saline challengeRecently we have evaluated hypertonic aerosols for cough A detailed description of the challenge has been publishedprovocati ...