Perception of dyspnea in childhood asthma crisis by the patients and those in charge of them

Abstract

Objective: To evaluate the correlation between perception of dyspnea during a mild to moderate asthma attack using the Modified Borg Scale (MBS) and peak expiratory flow rate (PEFR).Methods: This was a cross-sectional study conducted with children and adolescents who sought a pediatric emergency service due to an asthma attack. Data were collected from July 2005 to June 2006. Demographic data were recorded. Patients and those in charge of them were requested to grade, individually, the patient's dyspnea using the MBS; afterwards, the PEFR was measured.Results: 181 asthmatic patients were evaluated, with a mean age of 7.2 (± 2.4) years (range, 4-12). The mother sought medical aid in 83.4% of the cases (151/181). Patient symptoms included coughing in 68.5% (124/181), dyspnea in 47.0% (85/181), and wheezing in 12.7% (23/181). Thirty-six percent (65/181) had a mild attack, and 64.1% (116/181) a moderate one. A significant negative correlation was found between the patients' and accompanying adults' perceptions of patient's dyspnea and the PEFR (% predicted; r s = -0.240 and r s = -0.385, respectively). Conclusion:Both the patients and those looking after them had a poor perception of the severity of the patient's dyspnea. This emphasizes the need to monitor objective measures such as the PEFR and to develop better ways of evaluating dyspnea.J Pediatr (Rio J). 2011;87(6):541-6: Perception, asthma and dyspnea. ResumoObjetivo: Avaliar a correlação entre a percepção da dispneia durante uma crise de asma leve a moderada, por meio da escala modificada de Borg, com a medida do pico de fluxo expiratório (PFE). Métodos IntroduçãoA percepção pode ser definida como sensação consciente de um problema fisiológico apreciada pelo paciente. É o resultado final de uma série de processos: ativação de terminações aferentes por estímulos fisiopatológicos, transmissão e processamento de informações pelas vias neuronais, interpretação no córtex cerebral e reconhecimento pelo paciente.

Is there an association between the value of forced expiratory volume in the 1st second, the Asthma Control Test and a Control Framework by Global Initiative for asthma in asthmatic children and adolescents treated with inhaled corticosteroids?

“…The study remained on 56 patients who met the criteria: use of IC regularly, either alone or in combination with long-acting beta 2 agonist, at least 3 months and had none of the conditions (associated pulmonary comorbidity, inadequately performed spirometric tests, or incorrect completion of the C-ACT/ACT questionnaire). In the study sample (56 children) , it was found a predominance of males (58.9%) and a median age of 12 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) years. There was a statistical association between FEV1 and GINA values (p <0.01), as well as between FEV1 values and those of C-ACT/ACT scores (p <0.01) in relation to controlled and untreated patients.…”

“…In those under treatment, there was no correlation between C-ACT score and FEV 1 values. Poor perception of symptoms by patients and their families may explain this finding, as the Asthma Control Test is a selfapplicable tool that considers only clinical parameters and not spirometric parameters such as FEV 1 16,17 .…”

“…Resultados: Do total de prontuários avaliados (72), 16 crianças foram excluídas por não preencherem os critérios exigidos para realização da espirometria. A amostra estudada (56 crianças) apresentou predomínio do sexo masculino (58,9%) e mediana de idade igual a 12 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) anos. Observou-se associação entre os valores de VEF1 e o GINA (p<0,01).…”

Survenue de symptômes tardifs après un test de provocation par la méthacholine

“…Il n'y avait pas de différence concernant les valeurs pré-test des EFR dans les deux groupes (TPM+ et TPM-). La similitude de la proportion de sujets atopiques chez les patients TPM+ et TPM− est en revanche inhabituelle [12]. L'explication repose probablement sur le recueil de cette information uniquement lié à l'interrogatoire du patient.…”

Dyspnea Perception During Induced Bronchoconstriction Is Complicated by the Inhaled Methacholine in Children With Clinical Asthma

“…2 Recurrent episodes of dyspnea or other relevant symptoms indicating airway obstruction are essential for the diagnosis of asthma, as well as the exclusion of other possible causes. 3 …”