Source: Annual Congress 2002 - Asthma - Therapy and management -2
Disease area: Airway diseases

Abstract

Aim of the work: To determine spirometric parameters best correlating with symptom improvement in acute asthma exacerbations treated in emergency department
Methods: Seventy asthmatics presenting to emergency department with worsening chest tightness were included. Spirometric assessment was carried out shortly after presentation and repeated 15-20 minutes after receiving treatment, (1ml of 0.5% nebulized salbutamol solution and 2 ml of 0.05% budesonide suspension). Spirometric measurements included forced vital capacity FVC, forced expiratory volume1 FEV1, peak expiratory flow rate PEFR, maximal expiratory flow rates: FEF75%, 50%, 25%, peak inspiratory flow rate PIFR, maximal inspiratory flow rates: FIF25%, 50%, 75%. Patients ranked improvement of their dyspnea using a 10-cm visual analogue scale.
Results: The study included 39 males and 31 females, 29±]12 years old. Patients reported an average subjective improvement of 6.6±]1.2. All spirometric parameters improved significantly after treatment (p<0.05). The best correlation was found with ΔFIF25% (r=0.31, p<0.02), and ΔFEF75% (r=0.28, p<0.05). Non significant correlation was found with other spirometric parameters. Correlation was better for ΔPIFR (r=0.22) compared to ΔPEFR (r=0.16). Least correlation was found with ΔFVC (r=0.14) and ΔFEV1(r=0.14).
Conclusion: PIFR and PEFR correlate poorly with symptom improvement in asthma exacerbations. However they are easy-to-perform procedures and either of them can be used for domiciliary monitoring of asthma patients. Other spirometric parameters as FIF25% and FEF75% are more sensitive. They may prove better for assessment of asthma patients in primary care and emergency departments where simple electronic spirometers are available.

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Citations should be made in the following way:
M. M. Khalil (Cairo, Egypt). Spirometric correlates of symptom improvement in asthma patients presenting to emergency department. Physiology and practice. Eur Respir J 2002; 20: Suppl. 38, 403

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