LA phonospirometry technique compared to pediatric respiratory assessment measure and peak expiratory flow measurement as a novel technique to assess the severity of an asthma exacerbation

Abstract

Objective: Asthma is a common chronic disease treated in emergency departments. The measurements of Peak Expiratory Flow (PEF) and Pediatric Respiratory Assessment Measure (PRAM) scores have been recommended as objective techniques in the assessment of acute asthma exacerbations, but have multiple barriers limiting their use. The Los Angeles phonospirometry technique is an easier, trans-cultural technique. The technique assesses dyspnea by measuring how many seconds a child is able to chant “LA LA LA” in a single breath. The objective of this study is to determine the correlation of this technique with PEF measurements and PRAM scores in children with acute asthma exacerbations, both before and after nebulized bronchodilator treatment. Methods: A convenient sample of children aged 5–17 years being treated for asthma in the ED was enrolled. Phonospirometry, PRAM, and PEF measurements were obtained through pre and post inhaled bronchodilator treatments. The highest values from each measurement were correlated using Spearman's correlation coefficient. Results: A total of 91 children were enrolled. The correlations at pre-treatment, after first, second, and third treatments between phonospirometry and PEF were 0.38 (p < 0.001), 0.60 (p < 0.001), 0.54 (p < 0.001), 0.52 (p < 0.01), respectively; between phonospirometry and PRAM were −0.37 (p < 0.001), −0.42 (p < 0.001), −0.26 (p < 0.05), and −0.06 (p > 0.05), respectively; and between PEF and PRAM were −0.6 (p < 0.01), −0.54 (p < 0.001), −0.38 (p < 0.01), and −0.36 (p − 0.05), respectively. Conclusions: This novel technique correlates mild to moderately with PEF, and shows promising aide in the assessment of children with acute asthma exacerbations.

Keywords:

• Pediatrics
• children
• bronchodilation
• emergency department
• dyspnea

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.

Acknowledgements

The authors would like to thank Phung Pham and Colleen G. Azen, M.S. of the GCRC/CTSI at Children’s Hospital Los Angeles for their support with the statistical analysis.

Additional information

Funding

This research was funded in part by the American Academy of Pediatrics Section on Emergency Medicine’s Ken Graff Endowment. Funded also in part by the National Center for Advancing Translational Sciences (NCATS) at the National Institute of Health, grant number UL1TR00013. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.