Pico de fluxo expiratório: é melhor medir!

Cruz, Álvaro Augusto

doi:10.1590/s1806-37132006000100003

Cited by 8 publications

(7 citation statements)

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“…( 27 , 28 ) Objective measures of lung function, such as PEF and FEV 1 , are useful predictors of hospital admission in such patients. ( 29 ) In the present study, the patients who eventually died had presented worse lung function than had those who did not. A decline in FEV 1 has been shown to be associated with death from asthma.…”

Section: Discussionsupporting

confidence: 39%

Risk factors for death in patients with severe asthma

Fernandes¹,

Souza-Machado

Coelho

et al. 2014

J. bras. pneumol.

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OBJECTIVE: To identify risk factors for death among patients with severe asthma. METHODS: This was a nested case-control study. Among the patients with severe asthma treated between December of 2002 and December of 2010 at the Central Referral Outpatient Clinic of the Bahia State Asthma Control Program, in the city of Salvador, Brazil, we selected all those who died, as well as selecting other patients with severe asthma to be used as controls (at a ratio of 1:4). Data were collected from the medical charts of the patients, home visit reports, and death certificates. RESULTS: We selected 58 cases of deaths and 232 control cases. Most of the deaths were attributed to respiratory causes and occurred within a health care facility. Advanced age, unemployment, rhinitis, symptoms of gastroesophageal reflux disease, long-standing asthma, and persistent airflow obstruction were common features in both groups. Multivariate analysis showed that male gender, FEV1 pre-bronchodilator < 60% of predicted, and the lack of control of asthma symptoms were significantly and independently associated with mortality in this sample of patients with severe asthma. CONCLUSIONS: In this cohort of outpatients with severe asthma, the deaths occurred predominantly due to respiratory causes and within a health care facility. Lack of asthma control and male gender were risk factors for mortality.

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Section: Discussionsupporting

confidence: 39%

Risk factors for death in patients with severe asthma

Fernandes¹,

Souza-Machado

Coelho

et al. 2014

J. bras. pneumol.

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“…treatment protocols. (14,(21)(22)(23)(24)(25)(26)(27) In addition, the judicious evaluation of patient histories, the risks associated with the disease and the determination of pulmonary function parameters are frequently ignored. We highlight the fact that six patients in this series reported no hospitalizations; two of these reported no visits to emergency rooms until the time of death.…”

Section: Discussionmentioning

confidence: 99%

“…(26,27) Peak expiratory flow, measured serially (at 15 min and 4 h after the initiation of treatment) in the emergency room, is a good prognostic marker of the outcome of the asthma attack. (27) Signs and symptoms guide therapeutic procedures, but repeated measurements of pulmonary function parameters contribute to the evaluation of the intensity of bronchial obstruction and the response to the recommended treatment.…”

Section: Discussionmentioning

confidence: 99%

“…(1,4,21) The lack of asthma control in this subgroup of patients can be attributed to various factors: denial or underestimation of the disease by the patients; insufficient treatment for the severity of the disease; lack or incorrect use of asthma medications; limited access to health care services; presence of comorbidities; and factors inherent to the disease. (21)(22)(23)(24)(25)(26)(27)(28) Some authors have found that the use of inhaled corticoids is inversely proportional to the risk of death from asthma. (3) In the present study, we found that mortality was more common during the first 12 months of treatment for asthma, which suggests that the anti-inflammatory treatment period might have been cumulatively insufficient.…”

Section: Discussionmentioning

confidence: 99%

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Causas de óbitos entre asmáticos graves admitidos no Programa de Controle da Asma e da Rinite Alérgica na Bahia

et al. 2007

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Objective: To report demographic and clinical characteristics of patients with asthma who evolved to death, as well as to describe the conditions related to this outcome in a subgroup of patients admitted to the Program for the Control of Asthma and Allergic Rhinitis in Bahia (ProAR). Methods: A descriptive, retrospective, observational study. Data from clinical charts and death certificates of 16 patients of 930 subjects with severe asthma monitored at the ProAR Central Reference Center from December 2003 to June 2006 were reviewed. Results: Of the 930 patients participating in the program, 16 (1.72%) died. Of these, there were 10 males and 6 females, ranging in age from 39 to 74 years (median, 55 years); 12 (75%) of the patients were black. Time since diagnosis ranged from 1 to 68 years (median, 30 years). In 43.8 and 53.8%, respectively, there was a personal or family history of atopy. Ex-smokers (<10 pack-years) accounted for 37.5% of the cases. Causes of death listed on the death certificates were as follows: asthma or asthma exacerbations in 8 (50%); respiratory failure in 3 (18.75%); acute heart infarction in 2 (12.5%); hepatitis in 1 (6.25%); hypovolemic shock in 1 (6.25%); and cardiorespiratory arrest in 1 (6.25%). Of the 16 deaths, 13 (81.25%) occurred inside hospitals. Conclusion: Asphyxia and cardiovascular diseases were the most common attributed causes of mortality in this subgroup of patients with severe asthma. Hospital-based mortality, male gender, advanced age, long-term disease and fixed airflow obstruction were the aspects most frequently observed in the cases studied.

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“…In patients with respiratory problems, dyspnea is one of the most common symptoms, and it can show significant complications, implying the risk of asphyxia by lack of adequate treatment (6) . The perception of the symptom is defined as the patient's conscious sensation of a physiological problem, the result of a series of events: activation of the afferent endings by physiopathological stimulation, information transmission and processing in the nerve ways, interpretation at the brain cortex and finally, recognition by the patient (7) .…”

Section: Introductionmentioning

confidence: 99%

The use of Borg's modified scale in asthma crises

et al. 2008

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Objective: Verify the correlation of the improvement of the degree of dyspnea by BME with improved pulmonary performance verified by Expiratory Flow Peak (EFP) and Peripheral Oxygen Saturation (PO 2 S). Methods: Analytical, cross-sectional study with 124 patients during an asthma crisis, who received care at a Pneumology emergency service. Heart rate, respiratory frequency EFP, PO 2 S were evaluated before and after treatment of asthma crisis, and they were questioned about their perception of dyspnea by BME. Results: In the pretreatment stage, high scale values were related to low EFP values, inverting this relation after treatment. There was also a slight correlation between EFP, PO 2 S and the perception of dyspnea measured by the patient through BME. Conclusion: The scale does not replace other clinical parameters, and can be used as an additional tool, provided that the patient is correctly informed about the scale values. Keywords: Dyspnea; Asthma; Scales RESUMOObjetivo: Verificar a correlação da melhora do grau de dispnéia pela EMB com a melhora da função pulmonar verificada pelo Pico de Fluxo Expiratório (PFE) e Saturação Periférica de Oxigênio (spO 2 ).Métodos: Estudo analítico e transversal com 124 pacientes em crise asmática atendidos em um Pronto-Atendimento em Pneumologia. Foram avaliados antes e após o tratamento da crise asmática: frequência cardíaca, frequência respiratória, PFE, SpO 2 e questionados sobre sua percepção da dispnéia pela EMB. Resultados: Na fase pré-tratamento, valores altos da escala estavam relacionados a valores baixos de PFE, invertendo esta relação no pós-tratamento. Houve também uma fraca correlação entre o PFE, SpO 2, e a percepção da dispnéia mensurada pelo paciente através da EMB. Conclusão: A escala não substitui outros parâmetros clínicos, podendo ser utilizada como uma ferramenta adicional, desde que o paciente seja corretamente informado sobre os valores da escala. Descritores: Dispnéia; Asma; Escalas RESUMEN Objetivo: Verificar la correlación de la mejoría del grado de disnea por medio de la EMB con la mejora de la función pulmonar verificada por el Pico de Flujo Expiratorio (PFE) y Saturación Periférica de Oxígeno (spO 2 ).Métodos: Estudio analítico y transversal realizado con 124 pacientes en crisis asmática atendidos en un Servicio de emergencia de neumología. Fueron evaluados antes y después del tratamiento de la crisis asmática: frecuencia cardiaca, frecuencia respiratoria, PFE, SpO 2 e interrogados sobre su percepción de la disnea por medio de la EMB. Resultados: En la fase de pre-tratamiento, los valores altos de la escala estaban relacionados a los valores bajos de PFE, invirtiéndose esta relación en el post-tratamiento. Hubo también una débil correlación entre el PFE, SpO 2, y la percepción de la disnea mensurada por el paciente a través de la EMB. Conclusión: La escala no sustituye otros parámetros clínicos, pudiendo ser utilizada como una herramienta adicional, siempre y cuando el paciente sea correctamente informado sobre los valores de la escala.

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Pico de fluxo expiratório: é melhor medir!

Cited by 8 publications

References 8 publications

Risk factors for death in patients with severe asthma

Risk factors for death in patients with severe asthma

Causas de óbitos entre asmáticos graves admitidos no Programa de Controle da Asma e da Rinite Alérgica na Bahia

The use of Borg's modified scale in asthma crises

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