PT - JOURNAL ARTICLE AU - Wilfried Nikolaizik AU - Lisa Wuensch AU - Monika Bauck AU - Volker Gross AU - Keywan Sohrabi AU - Andreas Weissflog AU - Olaf Hildebrandt AU - Ulrich Koehler AU - Stefanie Weber TI - Pilot study on nocturnal monitoring of crackles in children with pneumonia AID - 10.1183/23120541.00284-2021 DP - 2021 Jan 01 TA - ERJ Open Research PG - 00284-2021 4099 - http://openres.ersjournals.com/content/early/2021/09/16/23120541.00284-2021.short 4100 - http://openres.ersjournals.com/content/early/2021/09/16/23120541.00284-2021.full AB - Background The clinical diagnosis of pneumonia is usually based on crackles at auscultation but it is not yet clear what kind of crackles are the characteristic features of pneumonia in children. Lung sound monitoring can be used as a “longtime stethoscope”. Therefore, it was the aim of this pilot study to use a lung sound monitor system to detect crackles and to differentiate between fine and coarse crackles in children with acute pneumonia. The change of crackles during the course of the disease shall be investigated in a follow-up study.Patients and methods Crackles were recorded overnight from 22.00 to 06.00 h in 30 children with radiographically confirmed pneumonia. The data of a total of 28 800 recorded 30-second-epochs were audiovisually analysed for fine and coarse crackles.Results Fine crackles and coarse crackles were recognised in every patient with pneumonia but the number of epochs with and without crackles varied widely among the different patients: Fine crackles were detected in 40% (mean, sd 22), coarse crackles in 76% (sd 20). The predominant localisation of crackles as recorded during overnight monitoring was in accordance with the radiographic infiltrates and the classical auscultation in most patients. The distribution of crackles was fairly equal throughout the night. However, there were time periods without any crackle in the single patients so that the diagnosis of pneumonia might be missed at sporadic auscultation.Conclusion Nocturnal monitoring can be beneficial to reliably detect fine and coarse crackles in children with pneumonia.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Nikolaizik has nothing to disclose.Conflict of interest: Lisa Wünsch has nothing to disclose.Conflict of interest: Monika Bauck has nothing to disclose.Conflict of interest: Prof. Dr. Gross has nothing to disclose.Conflict of interest: Dr. Sohrabi has nothing to disclose.Conflict of interest: Dr. Weissflog has nothing to disclose.Conflict of interest: Dr. Hildebrandt has nothing to disclose.Conflict of interest: Dr. Koehler reports grants and personal fees from Löwenstein Medical, outside the submitted work.Conflict of interest: Prof. Dr. Weber has nothing to disclose.