The Journal of asthma : official journal of the Association for the Care of Asthma
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National Asthma Education and Prevention Program recommended emergency department (ED) asthma treatment includes both providing systemic corticosteroids in the ED and a steroid prescription at discharge. ⋯ Substandard ED asthma care is common, even among visits by patients with more severe asthma exacerbations.
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To examine the time-dependent changes of spirometry (percent-predicted forced expiratory volume in 1 second [%FEV(1)]) and the Pediatric Respiratory Assessment Measure (PRAM) during the treatment of acute asthma exacerbations. ⋯ Most improvement of lung function and clinical severity occur in the first 2 hours of treatment. Among pediatric patients with acute asthma exacerbations, the PRAM detects significant and clinically meaningful change of severity during the second 2-hour treatment, whereas spirometry does not. This suggests that spirometry and clinical severity scores do not have similar trajectories and that clinical severity scores may be more sensitive to clinical change of acute asthma severity than spirometry.
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High-frequency chest wall oscillation (HFCWO) has been traditionally implemented for airway secretion clearance in conditions such as cystic fibrosis (CF) and bronchiectasis. There have been few reports of its use in refractory asthma. ⋯ High-frequency chest oscillation may be useful in phenotypes of asthma characterized by prominent mucus hypersecretion.
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Bronchial thermoplasty (BT) can provide relief for patients with severe, uncontrolled asthma despite maximal medical therapy. However, it is unclear whether BT is safe in patients with very severe airflow obstruction. ⋯ We suggest that BT may be safe for asthma patients with severe airflow obstruction and higher hospitalization rates than previously reported.
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Comparative Study
Detection of the airway obstruction stage in asthma using impulse oscillometry system.
Although spirometry is the most common method for evaluating the airway obstruction stage in asthma patients, it is difficult to perform in some patients. The aim of this study was to evaluate whether impulse oscillometry, an easy-to-perform technique, can detect asthmatic airway obstruction stage. ⋯ IOS provides an accurate, reliable, and patient-friendly technique for classifying asthmatic airway obstruction.