Crackles are common in patients with pneumonia and often clear when pneumonia resolves. Clinicians have long recognized that crackles often increase in number as congestive heart failure (CHF) worsens, and that crackles are more numerous in late-stage than in early-stage interstitial pulmonary fibrosis (IPF). The degree of profusion of crackles often reflects the severity of disease. 4, 6Ĭrackles are important abnormal lung sounds. Numerous studies support the hypothesis that computerized lung-sounds analysis has clinical value 1– 5 and can identify sounds as well as experienced clinicians do. Advances in acoustic technology now allow precise detection and quantification of lung sounds, so we have been studying computerized lung-sound analytic methods under the assumption that this technology can improve diagnosis and monitoring of cardiopulmonary disorders. Lung sounds detected over the chest reflect the underlying pulmonary pathophysiology. In patients with CHF the average crackle rate during normal breathing was not significantly different from that during the first deep-breathing maneuver (108%). 001) and significantly higher in the patients with IPF (147%, P <. However, during normal breathing the crackle rate was significantly lower in the patients with pneumonia (74%, P <. Similarly, the average crackle rate did not change significantly following coughing (pneumonia 105%, CHF 110%, IPF 90%) or the vital-capacity maneuver (pneumonia 102%, CHF 101%, IPF 99%). Compared to the first deep-breathing maneuver (100%), the average crackle pitch did not significantly change following coughing (pneumonia 100%, CHF 103%, IPF 100%), the vital-capacity maneuver (pneumonia 100%, CHF 92%, IPF 104%), or during quiet breathing (pneumonia 97%, CHF 100%, IPF 104%). Crackle rate variability was also small: pneumonia 31%, CHF 32%, IPF 24%. RESULTS: Crackle pitch variability, expressed as a percentage of the average crackle pitch, was small in all patients and in all maneuvers: pneumonia 11%, CHF 11%, pulmonary fibrosis 7%.
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