Evaluation of severity of bronchial asthma through an exercise bronchial challenge.
Lazo-Velásquez JC1, Lozada AR, Cruz HM.
1Primary Care Service, Ministry of Health, Arequipa, Peru. jucar105@hotmail.com
Abstract
Optimum treatment of
bronchial asthma requires accurate diagnosis and severity
classification. We studied the use of an exercise bronchial challenge in
the asthmatic patient as a diagnostic tool. An exercise bronchial
challenge test was carried out in 431 asthmatic children and 114
children without a history of asthma in a moderate-altitude environment
(2,230 m above sea level/7,314 feet above sea level). Values of peak
expiratory flow (baseline and maximum fall) were analyzed through time
in each asthma severity group (intermittent, mild persistent, moderate
persistent, severe persistent, and nonasthmatic controls). There was a
significant difference among responses of asthma severity groups for
almost all variables. No difference was found between nonasthmatic and
intermittent groups who had similar behavior, except in bronchodilator
response. An exercise bronchial challenge helps classify a patient
according to asthma severity; it is easy to reproduce and does not
require expensive equipment. It allows diagnosing and classifying asthma
severity easily and supplementing the clinical evaluation. Based on our
results, we propose a fall of PEF >or= 11% as new cutoff point for
making a diagnosis of persistent bronchial asthma. A fall of 11-25%
indicates mild persistent asthma; from 25-50%, moderate persistent
asthma; and a bigger fall, severe persistent asthma.
Pediatr Pulmonol. 2005 Nov;40(5):457-63.
http://onlinelibrary.wiley.com/doi/10.1002/ppul.20275/abstract
Md. Juan Carlos Lazo Velásquez. Fundador del GII
