Children's perception of breathlessness in acute asthma

Male, Ian; Richter, Hazel; Seddon, Paul

doi:10.1136/adc.83.4.325

Cited by 27 publications

(14 citation statements)

References 35 publications

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“…19 20 The sample also had a high proportion of mild asthma (BTS step 2), which may explain why no effect of either treatment or asthma severity was found. It was expected that children with severe asthma would have blunted perception (as has previously been shown, 16 and would be expected by a simple application of Weber's Law), but there were small numbers of children on BTS steps 3 and 4 medication. There was no effect of habitual level of exercise, attitude towards exercise, or competitiveness, which were expected to alter "norms" and hence the perception of EIA.…”

Section: Methodological Issuesmentioning

confidence: 86%

Kindergarten-based outbreak of perianal group A streptococcal infection

2003

Archives of Disease in Childhood

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Background: Exercise induced asthma (EIA) plays an important role in clinical evaluation. There has been little previous work validating EIA as reported directly by children and indirectly by their parents. Aims: (1) To determine the strength of the association between children's symptoms of EIA and their physiological response to exercise in a laboratory setting. (2) To compare parents' perception of EIA with that of their children. (3) To seek factors influencing the perception of EIA. Methods: Forty three asthmatic children and their parents answered a questionnaire, which included measures of symptom perception in EIA using visual analogue (VAS) and Likert scales. The children underwent a standardised treadmill exercise challenge, using spirometry to measure the physiological outcome, after which they and their parents independently completed the symptom scores. Twenty four subjects agreed to return for a second visit, in order to assess repeatability. Results: The VAS and Likert scales were highly correlated. Children's symptom perception as measured by change in VAS scores related weakly to change in FEV 1 after exercise, and was unaffected by confounding factors such as age, gender, medication, and habitual exercise. Parents' perception of symptoms was unrelated to any physiological measure. There was no significant relation between parent and child VAS scores after exercise, and there was poor agreement between the Likert scale scores after exercise. The repeatability of the perception of change in FEV 1 after exercise was poor for both parents and children. Conclusion: Physicians should obtain reports of EIA from children rather than parents, but be aware of their limited accuracy and repeatability.

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Section: Methodological Issuesmentioning

confidence: 86%

Kindergarten-based outbreak of perianal group A streptococcal infection

2003

Archives of Disease in Childhood

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“…Considering the physiopathology of acute asthma, the response to treatment in exacerbations seems to have a two-phase course, i.e., a quick initial response followed by a slower one (17)(18)(19)(20). The quick phase is probably related to the improvement of smooth muscle contraction (18) and patients in whom this is the major contribution to their disability respond quite well to minimal treatment, even if the obstruction is significant. The slow phase probably depends on the time www.bjournal.com.br needed to heal the inflammatory process, which has a rather more indolent behavior.…”

Section: Discussionmentioning

confidence: 99%

Correlations between pulse oximetry and peak expiratory flow in acute asthma

Andrade

Duarte

Camargos

2007

Braz J Med Biol Res

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Few studies are available concerning correlations between pulse oximetry and peak expiratory flow in children and adolescents with acute asthma. Although the Global Initiative for Asthma states that measurements of lung function and oximetry are critical for the assessment of patients, it is not clear if both methods should necessarily be included in their evaluation. Since there is a significant difference in cost between pulse oximetry equipment and peak expiratory flow devices, we determined whether clinical findings and peak expiratory flow measurements are sufficient to determine the severity of acute asthma. The present prospective observational study was carried out to determine if there is correlation between pulse oximetry and peak expiratory flow determination in 196 patients with acute asthma aged 4 to 15 years diagnosed according to the Global Initiative for Asthma criteria. Patients experiencing their first or second wheezing episode, with fever, related acute or chronic diseases, and unable to perform the peak expiratory flow maneuver were excluded. Measurements of peak expiratory flow and pulse oximetry were performed at admission and after 15 min of each inhaled salbutamol cycle. Correlations obtained by linear regression using the Pearson correlation coefficients (r) were 0.41 (P < 0.0001), 0.53 (P < 0.0001), 0.51 (P < 0.0001), and 0.61 (P < 0.0001) at admission and after the first, second and third cycles of salbutamol, respectively. These correlations showed that one measure cannot substitute the other (Pearson's coefficient <0.7), probably because they evaluate different aspects in the airways, suggesting that peak expiratory flow should not be used alone in the assessment of acute asthma in children and adolescents.

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“…3 Children with long-standing airways obstruction are less likely to report dyspnoea than children with acute onset of airways obstruction. 4 Such poor perceivers are more likely to present with hypoxia during an acute exacerbation, 5 predisposing to severe or life threatening attacks. Thus, evidence supports the hypothesis that poor perception of airways obstruction is a clinically relevant problem in children with asthma.…”

Section: Why Monitor Lung Functionmentioning

confidence: 99%

Usefulness of monitoring lung function in asthma

Brand

2003

Archives of Disease in Childhood

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Children's perception of breathlessness in acute asthma

Cited by 27 publications

References 35 publications

Kindergarten-based outbreak of perianal group A streptococcal infection

Kindergarten-based outbreak of perianal group A streptococcal infection

Correlations between pulse oximetry and peak expiratory flow in acute asthma

Usefulness of monitoring lung function in asthma

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