Written by Hannah Harp
Spoon Feed
Digital ‘wheeze detector’ devices can be used at home to aid parents in assessing their child’s need for short-acting beta-agonist (SABA) rescue therapy, though patterns of device use differ from family to family.
A breath of fresh air
Wheeze in toddlers and young children, whether from respiratory illness, juvenile asthma, or reactive airway disease can feel like a nebulous symptom. Because young children can’t complete pulmonary function testing, gathering objective data about the cause, character, and prognosis of a wheeze is difficult at this age. The results of this secondary analysis of a prior randomized trial are encouraging. There was concordance between parental perceived wheeze and device-detected wheeze of 75%, and that value increased as the study progressed, suggesting parents were becoming more in tune with their child’s symptoms by using the detector regularly. But there were no patient-centered outcomes in this study, such as reduced healthcare utilization. I’m convinced that such a device would be utilized by families, and it’s evident that parents took cues from the readings when deciding to treat their children with a rescue inhaler.
How this will change my practice?
I get a lot of questions about how to know when it’s the right time to give a kid albuterol, and I wish I could give parents more specific answers. A device like this could come in handy for so many of my patients with asthma, especially as their families are adjusting to the diagnosis and getting into the rhythm of controller-rescue treatment. Of course, not all children with asthma experience wheeze, and wheeze isn’t the only indication for rescue, but I’ll take what I can get when it comes to demystifying the disease. So while it won’t be changing my practice just yet, I’m interested to see where devices like these take us in the future—hopefully to a world with fewer exacerbations and hospitalizations.
Source
Objective detection of wheeze at home by parents through a digital device: usage patterns and relationship with SABA administration. Pediatr Pulmonol. 2024 Oct 25. doi: 10.1002/ppul.27295. Epub ahead of print. PMID: 39451025
