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Titre du document / Document title

Utility of the expiratory capnogram in the assessment of bronchospasm

Auteur(s) / Author(s)

YARON M. (1 2) ; PADYK P. (3) ; HUTSINPILLER M. (3) ; CAIRNS C. B. (1 2) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Division of Emergency Medicine, University of Colorado Health Sciences Center, Denver, Colorado, ETATS-UNIS
(2) Colorado Emergency Medicine Research Center, University of Colorado Health Sciences Center, Denver, Colorado, ETATS-UNIS
(3) Denver Health and Hospitals Residency in Emergency Medicine, Denver, Colorado, ETATS-UNIS

Résumé / Abstract

Study objective : To determine whether the plateau phase of the expiratory capnogram (dco2/dt) can detect bronchospasm in adult asthma patients in the emergency department and to assess the correlation between dco2/dt and the peak expiratory flow rate (PEFR) in spontaneously breathing patients with asthma and in normal, healthy volunteers. Methods : We carried out a prospective, blinded study in a university hospital ED. Twenty adults (12 women) with acute asthma and 28 normal adult volunteers (15 women) breathed through the sampling probe of an end-tidal CO2 monitor, and the expired CO2 waveform was recorded. The dco2/dt of the plateau (alveolar) phase for five consecutive regular expirations was measured and a mean value calculated for each patient. The best of three PEFRs was determined. The PEFR and dco2/dt were also recorded after treatment of the asthmatic patients with inhaled β-agonists. Results : The mean±SD PEFR of the asthmatic subjects was 274±96 L/minute (57% of the predicted value), whereas that of the normal volunteers was 527±96 L/minute (103% of the predicted value) (P<.001). The mean dco2/dt of the asthmatic subjects (.26±.06) was significantly steeper than that of the normal volunteers (.13±.06) (P<.001). The dco2/dt was correlated with PEFR (r=.84, P<.001). In 18 asthmatic subjects the pretreatment and posttreatment percent predicted PEFRs were 58%±17% and 74%±17%, respectively (P<.001), whereas the dco2/dt values were.27±.05 and.19±.07, respectively (P<.005). Conclusion : The dco2/dt is an effort-independent, rapid, noninvasive measure that indicates significant bronchospasm in ED adult patients with asthma. The dco2/dt value is correlated with PEFR, an effort-dependent measure of airway obstruction. The change in dco2/dt with inhaled β-agonists may be useful in monitoring the therapy of acute asthma.

Revue / Journal Title

Annals of emergency medicine    ISSN  0196-0644   CODEN AEMED3 

Source / Source

1996, vol. 28, no4, pp. 403-407 (20 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1980) (Revue)

Mots-clés anglais / English Keywords

Bronchospasm

;

Capnography

;

Expiration

;

Asthma

;

Evaluation

;

Adult

;

Human

;

Respiratory disease

;

Bronchus disease

;

Obstructive pulmonary disease

;

Mots-clés français / French Keywords

Bronchospasme

;

Capnographie

;

Expiration

;

Asthme

;

Evaluation

;

Adulte

;

Homme

;

Appareil respiratoire pathologie

;

Bronche pathologie

;

Bronchopneumopathie obstructive

;

Mots-clés espagnols / Spanish Keywords

Broncoespasmo

;

Capnografía

;

Espiración

;

Asma

;

Evaluación

;

Adulto

;

Hombre

;

Aparato respiratorio patología

;

Bronquio patología

;

Broncopneumopatía obstructiva

;

Localisation / Location

INIST-CNRS, Cote INIST : 19670, 35400006635107.0050

Nº notice refdoc (ud4) : 3232485



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