Avaliação prognóstica precoce da asma aguda na sala de emergência

Abstract

Our results suggest that measuring peak expiratory flow after 15 minutes of management in the emergency room is a useful tool for predicting outcomes in cases of acute asthma.

The use of Borg's modified scale in asthma crises

“…Even though spirometry is considered the best method to evaluate the limitation of air flow in asthma, EFP measurement is easier to perform in emergency services. Besides, the devices used for EFP are less expensive and more readily available at this sector (26) . In our study, patients with varied levels of airflow obstruction were selected, from light/moderate crisis to very grave crisis.…”

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

“…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.…”

“…(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. (27) Simple resources for the determination of pulmonary function parameters are unavailable in most Brazilian hospitals, particularly in our state.…”

“…(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. (27) Simple resources for the determination of pulmonary function parameters are unavailable in most Brazilian hospitals, particularly in our state. This might have been one of the factors that made the evaluation of these patients more difficult and contributed to their not being hospitalized, which would account for the fact that a great number of the deaths occurred in emergency rooms.…”

“…(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.…”