The pitch of an individual wheeze is determined not by the diameter of the airway but by the thickness of the airway wall, bending stiffness, and longitudinal tension. A wheeze is produced by the oscillation of opposing walls of an airway narrowed almost to the point of closure. In sound analysis, the wheeze appears as sinusoidal oscillations with sound energy in the range of 100 to 1000 Hz and with harmonics that exceed 1000 Hz on occasion ( figure 1). Its long duration, typically more than 100 msec, allows its musical quality to be discerned by the human ear. ![]() The emergent evaluation of children with acute respiratory distress (see "Acute respiratory distress in children: Emergency evaluation and initial stabilization")ĭEFINITION AND PHYSIOLOGY OF WHEEZING - Wheezing is probably the most easily recognized adventitious sound.Virus-induced wheezing (see "Role of viruses in wheezing and asthma: An overview" and "Treatment of recurrent virus-induced wheezing in young children").The diagnosis and management of childhood asthma (see "Asthma in children younger than 12 years: Initial evaluation and diagnosis" and "Asthma in children younger than 12 years: Management of persistent asthma with controller therapies").An overview of recurrent wheezing phenotypes in children (see "Wheezing phenotypes and prediction of asthma in young children").Other topics that cover related areas include: The role of the treating clinician is to try to reach the most likely diagnosis as quickly and efficiently as possible so that therapy, if necessary, can be instituted and caregiver concerns can be addressed.Ī diagnostic approach to wheezing in childhood is presented in this topic review. Wheezing may be either a benign, self-limited process or the presenting symptom of a significant respiratory disease. A large worldwide study looking at older children showed a global prevalence of wheezing of 11.6 percent in children aged 6 to 7 years and 13.7 percent in children between 13 to 14 years of age. The overall prevalence in the US was 27 percent. The prevalence of these symptoms varied from 29 percent in Northern Europe to 48 percent in Southern Europe. ![]() Overall, 3077 (32 percent) reported recurrent cough, wheeze, or breathlessness in the preceding six winter months. In a 2007 survey in the US and Europe, a total of 9490 children aged one to five years were screened for respiratory symptoms. Subsequent reports continue to show similar prevalence. A nationwide survey performed in the United States between 19 showed that the prevalence for wheezing amongst 2 to 3 year olds was 26 percent and amongst 9 to 11 year olds was 13 percent. One in three children experience at least one acute wheezing illness before the age of three years. ![]() INTRODUCTION - Wheezing is a common presenting symptom of respiratory disease in infants and children.
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