medigraphic.com
ISSN 1405-1699 (Print)
Órgano Oficial del Colegio Mexicano de Alergia, Asma e Inmunología Pediátrica y de la Asociación Latinoamericana de Pediatría

2001, Number 3

<< Back Next >>

Alerg Asma Inmunol Pediatr 2001; 10 (3)

Clinical valuation and peak expiratory flow of the asthmatic crisis

Lara-Pérez EA, Muñoz-Maya IA, Estrada BM, Ugarte-Vivanco E

Language: Spanish
References: 29
Page: 82-87
PDF size: 279.00 Kb.


ABSTRACT

Introduction: The clinic (Wood) status of a patient underestimate the asthmatic crisis, been different from the peak expiratory flow (PEF), giving as a result; bad attention, exacerbation of the clinical picture and risks. The aim of this study was to compare Wood and FEM.
Material and method: Prospective, observational and comparatively study was done evaluating: Wood and FEM (Assess®) at the admission and discharges of urgencies, comparing the values with nominal, percentual and central tendency. Results: Total; 202 cases; male 124 (61.38%), female 78 (38.61%), age half 8 years 6 months, Entrance by Wood: mild 156 (77.22%), moderate 46 (22.77%) expenditure: mild 37 (18.31%), normal 165 (81.68%), entrance by FEM: mild 8 (3.96%), moderate 29 (14.35%), severe 165 (81.68%), to the discharge: normal 34 (16.83%), mild 39 (19.30%), moderate 92 (45.54%), and severe 37 (18.31%). To the admission t: 37.224 with p ‹0.0000, to the discharges: t: 27.752 with p ‹0.0000.
Discussion: In spite of being recommended the FEM for handling and control of the asthma, in the daily practice is not used. It is necessary; investigation, training and diffusion of the asthma programs and of the FEM.
Conclusions: The FEM is better and exact evaluation method of the asthmatic attack, diminishing the mistakes (in subjective evaluation).


REFERENCES

  1. British Thoracic Society. The British guidelines on asthma management. 1995 review and position statement. Thorax 1997; 52(Suppl. 1): S1-S21.

  2. Mendenhall AB, Tsien AY. Evaluation of physician and patient compliance with the use of peak flow meters in commercial insurance and Oregon health plan asthmatic populations. Ann Allergy Asthma Immunol 2000; 84(5): 523-527.

  3. Boggs PB, Wheeler D, Washburne WF, Hayati F. Peak expiratory flow rate control chart in asthma care: chart construction and use in asthma care. Ann Allergy Asthma Immunol 1998; 81: 6, 552-62.

  4. Alcock SM, Mamun M, Prescott RJ, Connolly CK. Symptoms and pulmonary function in asthma. Respir Med 1998; 92: 6, 849-57.

  5. Weytjens K, Malo JL, Cartier A, Ghezzo H, Delwiche JP, Vandenplas O. Comparison of peak expiratory flows and FEV1 in assessing immediate asthmatic reactions due to occupational agents. Allergy 1999; 54(6): 621-5.

  6. Thiadens HA, De Bock GH, Van Houwelingen JC, Dekker FW, De Waal MW, Springer MP, Postma DS. Can peak expiratory flow measurements reliably identify the presence of airway obstruction and bronchodilator response as assessed by FEV(1) in primary care patients presenting with a persistent cough? Thorax 1999; 54(12): 1055-60.

  7. Emond SD, Woodruff PG, Lee EY, Singh AK, Camargo CA Jr. Effect of an emergency department asthma program on acute asthma care. Ann Emerg Med 1999; 34(3): 321-5.

  8. McCarren M, Zalenski RJ, McDermott M, Kaur K. Predicting recovery from acute asthma in an emergency diagnostic and treatment unit. Acad Emerg Med 2000; 7(1): 28-35.

  9. Mendoza GR. Peak flow monitoring at home: an interactive process between you and your physician. In: Spector A, editor. Understanding asthma. Palatine III: American College of Allergy and Immunology, 1989; 155-62.

  10. Abisheganaden J, Ng SB, Lam KN, Lim TK. Peak expiratory flow rate guided protocol did not improve outcome in emergency room asthma. Singapore Med J 1998; 39(11): 479-84.

  11. Nolan S, Tolley E, Leeper K, Strayhorn Smith V, Self T. Peak expiratory flow associated with change in positioning of the instrument: comparison of five peak flow meters. J Asthma 1999; 36(3): 291-4.

  12. Homa DM, Mannino DM, Lara M. Asthma mortality in US. Hispanics of Mexican, Puerto Rican and Cuban Heritage, 1990-1995. Am J Respir Crit Care Med 2000;161 Pt 1(2): 504-509.

  13. Kokubu F, Nakajima S, Ito K, Makino S, Kitamura S, Fukuchi Y, Mano K, Sano Y, Inoue H, Morita Y, Fukuda K, Akiyama K, Adachi M, Miyamoto T. Hospitalization reduction by an asthma tele-medicine system. Arerugi 2000; 49(1): 19-31.

  14. Ueshima Y, Kikuchi T, Kaneko N, Kaneshige H, Suzuki H. Study of how to continue peak flow monitoring for patients with bronchial asthma: questionnaire to continuation and interruption patients. Arerugi 2000; 49(5): 420-7.

  15. Wood WD, Downes JJ, Lecks HI. A clinical scoring system for the diagnosis of respiratory failure. Am J Dis Child 1972; 123: 227-8.

  16. Salas-Ramírez M, Segura-Méndez NH, Martínez-Cairo CS. Tendencia de la mortalidad por asma en México. Bol. Oficina Sanit. Panam 1994; 116(4): 298-306.

  17. Baeza-Bacab MA, Albertos A, Nelly E. Prevalencia de asma en niños escolares de Mérida, Yucatán. Pan Am J Public Health 1997; 2(5): 299-302.

  18. Ortega-Cisneros M, Ramos-García B, Espíndola-Reyna G, Sienra-Monge JJL. Pruebas de función pulmonar en pediatría. Bol Med Hosp Infant Mex 1997; 54: 47-53.

  19. Hogg JC. The pathology of asthma. In: Holgate ST. Asthma, Physiology, inmunopharmacology and treatment. Londres: Academic Press 1993: 17-25.

  20. Rushford N, Tiller JW, Pain MC. Perception of natural fluctuations in peak flow in asthma: clinical severity and psychological correlates. J Asthma 1998; 35: 3, 251-9.

  21. Hacken NH, Timens W, Smith M, Drok G, Kraan J, Postma DS. Increased peak expiratory flow variation in asthma: severe persistent increase but not nocturnal worsening of airway inflammation. Eur Respir J 1998; 12: 3, 546-50.

  22. Gannon PF, Newton DT, Pantin CF, Burge PS. Effect of the number of peak expiratory flow readings per day on the estimation of diurnal variation. Thorax 1998; 53: 9, 790-2.

  23. Hankinson JL. Beyond the peak flow meter: newer technologies for determining and documenting changes in lung function in the workplace. Occup Med 2000; 15: 2, 411-20.

  24. Côté J, Cartier A, Malo JL, Rouleau M, Boulet LP. Compliance with peak expiratory flow monitoring in home management of asthma. Chest 1998; 113: 4, 968-72.

  25. Sawyer G, Miles J, Lewis S, Fitzharris P, Pearce N, Beasley R. Classification of asthma severity: should the international guidelines be changed? Clin Exp Allergy 1998; 28: 12, 1565-70.

  26. Thiadens HA, De Bock GH, Dekker FW, Huysman JA, Van Houwelingen JC, Springer MP, Postma DS. Value of measuring diurnal peak flow variability in the recognition of asthma: a study in general practice. Eur Respir J 1998; 12: 4, 842-7.

  27. Douma WR, Kerstjens HA, Rooyackers JM, Koëter GH, Postma DS. Risk of overtreatment with current peak flow criteria in self-management plans. Dutch CNSLD Study Group. Chronic Non-Specific Lung Disease. Eur Respir J 1998; 12: 4, 848-52.

  28. Louis R, Lau LC, Bron AO, Roldaan AC, Radermecker M, Djukanovic R. The relationship between airways inflammation and asthma severity. Am J Respir Crit Care Med 2000; 161: 1, 9-16.

  29. Van der Ent CK, Van der Grinten CP, Meessen NE, Luijendijk SC, Mulder PG, Bogaard JM. Time to peak tidal expiratory flow and the neuromuscular control of expiration. Eur Respir J 1998; 12: 3, 646-52.




2020     |     www.medigraphic.com