Alveolar Nitric Oxide and Peripheral Oxygen Saturation in Frequent Exacerbators with Asthma: A Pilot Study

2021 ◽  
pp. 1-11
Author(s):  
Andrea E. Sprio ◽  
Francesca Bertolini ◽  
Rossana Fucà ◽  
Stefano Levra ◽  
Vitina Carriero ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Phase Ii ◽  
Asthma Management ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Total Serum ◽  
Peripheral Oxygen Saturation ◽  
Cross Sectional ◽  
Exhaled No ◽  
Lower Oxygen

<b><i>Introduction</i></b>: Asthmatics can experience recurrent exacerbations (AEs), irrespectively of asthma severity. Airway inflammatory monitoring could be fundamental to optimize the asthma management. The present study evaluated whether exhaled NO concentrations in proximal and distal respiratory compartments are different in AE-prone patients in combination with T2 blood biomarkers and resting oxygen saturation (SpO<sub>2</sub>). <b><i>Methods</i></b>: In this observational cross-sectional study, 91 mild-to-severe asthmatics were enrolled. Clinical characteristics, blood and lung function parameters including SpO<sub>2</sub>, and F<sub>E</sub>NO were evaluated. On 50 randomly selected patients, C<sub>A</sub>NO and J<sub>aw</sub>NO were also analyzed. Then, patients were stratified in frequent exacerbators (FEs) or non-frequent exacerbators (nFEs), according to AE frequency in the previous year (phase I). Chart data were re-evaluated through a 12-month follow-up period post exhaled NO measurement to detect occurrence of novel AE (phase II). <b><i>Results</i></b>: FE asthmatics had poorer asthma control and required higher therapeutic intensity (<i>p</i> &#x3c; 0.05). F<sub>E</sub>NO, C<sub>A</sub>NO, and J<sub>aw</sub>NO were similar between FE and nFE. FE exhibited higher total serum IgE levels and residual volume values but reduced SpO<sub>2</sub> than nFE (<i>p</i> &#x3c; 0.05); SpO<sub>2</sub>&#x3c;96.5% characterized the FE patient (odds ratio = 2.94). In phase II, C<sub>A</sub>NO was higher in the group with novel AE at 1-month post-NO measurement (<i>p</i> &#x3c; 0.05), but not afterward. A higher prevalence of C<sub>A</sub>NO &#x3e;6 ppb was detected in asthmatics who developed AE within 1 month, suggesting its potential clinical use as biomarker in predicting near-future AE (RR = 11.20). <b><i>Conclusion</i></b>: AE-susceptible asthmatics are characterized by air trapping and distal airway inflammation in conjunction with lower oxygen saturation. C<sub>A</sub>NO and SpO<sub>2</sub> could exert specific roles, respectively, in predicting AE and monitoring FE asthmatics.

scholarly journals Evaluation of Knowledge of Oxygen Therapy and Reading of Flowmeter among the Health Workers in the Pediatric Unit of the Hospital Universitario San Ignacio, Bogotá, Colombia

2018 ◽  
Vol 59 (3) ◽  
pp. 1-8
Author(s):  
Elly Morros González ◽  
Diana Estrada Cano ◽  
Marcela Murillo Galvis ◽  
Jos Carlos Montes Correa ◽  
Nelcy Rodríguez Malagón ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Oxygen Saturation ◽  
Oxygen Therapy ◽  
Health Workers ◽  
Supplemental Oxygen ◽  
Cross Sectional Study ◽  
Peripheral Oxygen Saturation ◽  
Cross Sectional ◽  
Fraction Of Inspired Oxygen ◽  
Supplemental Oxygen Therapy

Introduction: Supplemental oxygen is considered a pharmaceutical drug; therefore, it can produce adverse effects. Lack of consensus regarding the reading of oxygen flowmeters and the peripheral oxygen saturation (SpO2) goals can influence clinical and paraclinical decisions and hospital stay length. Objective: To assess knowledge on oxygen therapy, adverse effects, SpO2 goals and reading of oxygen flowmeters among personnel in the Pediatric Unit at Hospital Universitario San Ignacio, Bogotá, Colombia. Methodology: Cross-sectional study derived from convenience sampling through a self-applied survey between December 2016 and January 2017. The poll evaluated topics on supplemental oxygen therapy fundamentals and adverse effects, SpO2 goals and flowmeter readings through flowmeters photographs indicating a specific fraction of inspired oxygen (FiO2). Results: The response rate was 77% from 259 subjects. 22% considered that the oxygen saturation either increases or remains the same during sleep periods in children. 78% of participants knew at least one complication associated to prolonged oxygen therapy and 67% due to supplemental oxygen concentration greater than required. In neonatal population, 10% considered oxygen saturation goals equal to or greater than 96%. In the flowmeter’s reading evaluation, incorrect answers ranged from 9 to 19%. Conclusion: It is imperative to reinforce updated concepts on oxygen therapy, with emphasis in SpO2 goals, adverse effects and appropriate flowmeter’s readings through periodic educational campaigns.

scholarly journals Severe Asthma Management, Patient Pathway, and Disease Burden in Russia: Country Results From Multi-Country Retrospective Cross-Sectional Study

2021 ◽  
Author(s):  
Zaurbek Aisanov ◽  
Oksana Kurbacheva ◽  
Alexander Emelyanov ◽  
Galina Ignatova ◽  
Lindsey Teichman ◽  
...  
Keyword(s):  
Phase I ◽  
Severe Asthma ◽  
Phase Ii ◽  
Healthcare Resource ◽  
Asthma Management ◽  
Cross Sectional Study ◽  
Blood Eosinophil ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patient Reported

Abstract Background Severe asthma is a poorly controlled disease in Russia which leads to significant healthcare resource use and costs. However, little is known about its burden and management in a real clinical practice in Russia. Here we report the results obtained in the Russian population during an international cross-sectional study. Methods The study comprised two phases: in Phase I data were collected retrospectively from medical records, while Phase II was a cross-sectional collection of patient-reported outcomes and up-to-date data. For Phase I, adult patients with severe asthma according to ERS/ATS criteria were enrolled. Phase I patients were enrolled into Phase II if they signed a written consent form. Data on demographics, history of asthma and comorbidities, treatment approach, and healthcare resource utilization were obtained in both phases. In Phase II, asthma control and health-related quality of life (HRQoL) were also evaluated. Results A total of 315 patients were included in Phase I of the study, 106 (33.6%) of them entered Phase II of the study. The study population included more female (n=211, 67.0%) than male patients (n=104, 33.0%). Majority of subjects were either obese (n=103, 39.8%) or overweight (n=94, 36.3%). The most common comorbidity was cardiovascular disease (n=217, 71.4%), followed by chronic respiratory disease (n=198, 68.8%), including COPD and allergies. Mean (SD) age at diagnosis of asthma and severe asthma were 42.9 (16.0) and 53.1 (13.2) years, respectively. There were 268 (85.1%) patients who had at least one exacerbation during last 12 months. Most subjects had only one blood eosinophil count in the last 12 months (n=143, 81.3%). Mean (SD) FEV1 was 56.9 (20.4) % predicted. The mean (SD) last serum IgE/(RAST) value was 254.3 (249.7) ng/mL. Asthma management was generally in line with guidelines. Most patients had poorly controlled asthma according to the ACT and impaired HRQoL. Conclusions In Russia, severe asthma patients had poor disease control, high hospital admission rates and multiple comorbidities. Eosinophil and IgE level measurements are not considered routine tests which might be a barrier for appropriate phenotyping and treatment selection, including prescription of biologics in course of disease management.

scholarly journals The potential role of local pharmacies to assess asthma control: an Italian cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Caminati ◽  
L. Cegolon ◽  
M. Bacchini ◽  
N. Segala ◽  
A. Dama ◽  
...  
Keyword(s):  
Asthma Control ◽  
Multinomial Logistic Regression ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Disease Assessment ◽  
Community Pharmacies ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Disease Community

Abstract Background Asthma control and monitoring still represents a challenge worldwide. Although the international guidelines suggest the interplay between secondary and primary care services as an effective strategy to control the disease, community pharmacies’ are seldom involved in asthma control assessment. The present cross-sectional study aimed at providing a picture of the relationship between asthma severity and control in community pharmacies within the health district of the city of Verona (Veneto Region, North-Eastern Italy). Methods A call for participation was launched through the Pharmacists’ Association of Verona. Patients referring to the participating pharmacies with an anti-asthmatic drug medical prescription and an asthma exemption code were asked to complete the Asthma Control Test (ACT) and a brief questionnaire collecting information on their age, sex, smoking status, aerobic physical exercise and usual asthma therapy, which also defined asthma severity. A multinomial logistic regression model was fitted to investigate the risk of uncontrolled as well as poorly controlled vs. controlled asthma (base). Results were expressed as relative risk ratios (RRR) with 95% confidence interval (95%CI). Results Fifty-seven community pharmacies accepted to participate and 584 asthmatic patients (54% females; mean-age: 51 ± 19 years) were consecutively recruited from 1st January to 30th June 2018 (6 months). Based upon ACT score 50.5% patients had a controlled asthma, 22.3% a poorly controlled and 27.2% uncontrolled. A variable proportion of patients with uncontrolled asthma were observed for every level of severity, although more frequently with mild persistent form of asthma. Most patients (92%) self-reported regular compliance with therapy. At multinomial regression analysis, patients under regular asthma treatment course (RRR = 0.33; 95%CI: 0.15; 0.77) were less likely to have an ACT< 16 compared to those not taking medications regularly. Conclusions Overall, our findings highlighted an unsatisfactory asthma control in the general population, independently of the severity level of the disease. Community pharmacies could be a useful frontline interface between patients and the health care services, supporting an effective asthma management plan, from disease assessment and monitoring treatment compliance to referral of patients to specialist medical consultancies.

scholarly journals Management of oxygen saturation monitoring in preterm newborns in the NICU: the Italian picture

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Serafina Perrone ◽  
◽  
Maurizio Giordano ◽  
Giuseppe De Bernardo ◽  
Paola Lugani ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Standard Operating Procedures ◽  
Specific Training ◽  
Related Factors ◽  
Cross Sectional ◽  
Survey Form ◽  
Standard Operating ◽  
Oxygen Monitoring

Abstract Background Although many studies emphasize the importance of using oxygen saturation (SpO2) targets in the NICUs, there is a wide variability in used saturation ranges among centers. Primary aim was to draw a representative picture on how the management of oxygen monitoring is performed in the Italian NICUs. Second aim was to identify healthcare-professionals related factors associated with oxygen targeting in the preterm population. Methods Cross-sectional study with data collection via an electronic survey form. A questionnaire containing pre-piloted and open questions on monitoring and management of the SpO2 was administered to neonatologists across the network of the Italian Society of Neonatology. The questions focused on: the infrastructure, specific training, healthcare professionals and patients-related factors. The results of the survey were anonymously collected, summarized and analyzed. Results Out of 378 questionnaires, 93 were correctly filled. Thirty-six different SpO2 ranges were observed. Centers using written standard operating procedures on oxygen management and SpO2 monitoring maintained a correct average range of SpO2 90–95%, avoided hyperoxia and reconsidered saturation targets in relation to comorbidities. 39.8% of responders disabled alarms during neonatal care. One center used biomarkers for complete monitoring of neonatal oxygenation status. Conclusions There is considerable variation in SpO2 targets for preterm infants in the Italian NICUs. Standard operating procedures and specific training for health care personnel are the main factors playing a role for the correct maintenance of the recommended oxygen targets in preterms.

scholarly journals Higher Omega-3 Index Is Associated with Better Asthma Control and Lower Medication Dose: A Cross-Sectional Study

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 74 ◽  
Author(s):  
Isobel Stoodley ◽  
Manohar Garg ◽  
Hayley Scott ◽  
Lesley Macdonald-Wicks ◽  
Bronwyn Berthon ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Airway Disease ◽  
Cross Sectional Study ◽  
Erythrocyte Membranes ◽  
Omega 3 ◽  
Asthma Control Questionnaire ◽  
Cross Sectional

Asthma is a chronic inflammatory airway disease, associated with systemic inflammation. Omega-3 polyunsaturated fatty acids (n-3 PUFA) have established anti-inflammatory effects, thus having potential as an adjunct therapy in asthma. This study aimed to compare erythrocyte n-3 PUFA in adults with (n = 255) and without (n = 137) asthma and determine the relationship between erythrocyte n-3 PUFA and clinical asthma outcomes. Subjects had blood collected, lung function measured and Juniper Asthma Control Questionnaire (ACQ) score calculated. Fatty acids were measured in erythrocyte membranes by gas chromatography, and the omega-3 index (O3I) was calculated (% eicosapentaenoic acid + % docosahexaenoic acid). O3I was similar in subjects with and without asthma (p = 0.089). A higher O3I was observed in subjects with controlled or partially controlled asthma (ACQ < 1.5) compared to subjects with uncontrolled asthma (ACQ ≥ 1.5) (6.0% (5.4–7.2) versus 5.6% (4.6–6.4) p = 0.033). Subjects with a high O3I (≥8%) had a lower maintenance dose of inhaled corticosteroids (ICS) compared to those with a low O3I (<8%) (1000 μg (400–1000) versus 1000 μg (500–2000) p = 0.019). This study demonstrates that a higher O3I is associated with better asthma control and with lower ICS dose, suggesting that a higher erythrocyte n-3 PUFA level may have a role in asthma management.

scholarly journals Autonomic modulation at rest and in response to postural change in adolescents with Duchenne muscular dystrophy: a cross-sectional study

2021 ◽  
Vol 79 (9) ◽  
pp. 766-773
Author(s):  
Mariana Viana Rodrigues ◽  
Mileide Cristina Stoco-Oliveira ◽  
Talita Dias da Silva ◽  
Celso Ferreira ◽  
Heloisa Balotari Valente ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Oxygen Saturation ◽  
Cross Sectional Study ◽  
Control Group ◽  
Autonomic Modulation ◽  
Postural Change ◽  
Cross Sectional

ABSTRACT Background: Analysis of autonomic modulation after postural change may inform the prognosis and guide treatment in different populations. However, this has been insufficiently explored among adolescents with Duchenne muscular dystrophy (DMD). Objective: To investigate autonomic modulation at rest and in response to an active sitting test (AST) among adolescents with DMD. Methods: Fifty-nine adolescents were included in the study and divided into two groups: 1) DMD group: adolescents diagnosed with DMD; 2) control group (CG): healthy adolescents. Participants’ weight and height were assessed. Lower limb function, motor limitations and functional abilities of the participants in the DMD group were classified using the Vignos scale, Egen classification and motor function measurement, respectively. The following variables were assessed before, during and after AST: systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (f), oxygen saturation and heart rate (HR). To analyze the autonomic modulation, the HR was recorded beat-by-beat. Heart rate variability (HRV) indices were calculated in the time and frequency domains. Results: Differences in relation to groups were observed for all HRV indices, except LF/HF, oxygen saturation, HR and f (p < 0.05). Differences in relation to time and the interaction effect between group and time were observed for RMSSD, SD1, SD2, SD1/SD2, LFms2 and LFnu, HFun, SBP and DBP (p < 0.05). Differences in relation to time were also observed for the indice SDNN, FC and f (p < 0.05). Conclusions: Performing the AST promoted reduced autonomic modulation and increased SBP, DBP and HR in adolescents with DMD.

scholarly journals Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study

2019 ◽  
Vol 4 ◽  
pp. 168 ◽  
Author(s):  
Harriet Mpairwe ◽  
Pius Tumwesige ◽  
Milly Namutebi ◽  
Marble Nnaluwooza ◽  
Tonny Katongole ◽  
...  
Keyword(s):  
Asthma Control ◽  
Asthma Management ◽  
Cross Sectional Study ◽  
P Value ◽  
Asthma Diagnosis ◽  
Sectional Study ◽  
Asthma Control Test ◽  
Cross Sectional ◽  
Children With Asthma ◽  
Control And Management

Background: Children from low- and middle-income countries have poor asthma control, mainly because of poor management. The extent of this problem in Uganda is not well known, but such information would be useful to guide policy and practice. We therefore conducted a cross-sectional study among schoolchildren with asthma in urban Uganda, to assess the level of asthma control and management. Methods: Schoolchildren aged 5-17 years were enrolled, asthma was diagnosed by the study medical team. Asthma control was assessed using the Asthma Control Test and the childhood Asthma Control Test. Data on previous asthma management was obtained using interviewer-led questionnaires. Data were analysed using multiple linear and multiple logistic regression. Results: We enrolled 561 children with asthma, of whom only 56% had ever had an asthma diagnosis. We categorised asthma as well-controlled (55.5%), partly-controlled (29.5%) and poorly-controlled (15.0%). Poor asthma control was associated with increasing age (adjusted regression coefficient [95% confidence interval], p-value: -1.07 [-1.20, -0.94], p<0.0001), concurrent allergic rhinitis (-1.33 [-2.28, -0.38], p=0.006), and city residence in early life (-1.99 [-3.69, -0.29], p=0.06). Regular use of inhaled asthma medication in the last 12 months was very low; 18.1% for salbutamol and 6.7% for inhaled corticosteroids. The main barriers to inhaled asthma medication use were lack of prescription (47.6%) and inaccurate diagnosis (38.8%). Increased inhaler use was associated with tertiary education of the fathers (adjusted odds ratio [95% confidence interval], p-value: 5.19 [2.39-11.28], p<0.0001), city residence in early life (4.66 [1.79-12.43], 0.002) and an asthma diagnosis prior to enrolment (11.39 [6.35-20.43], p<0.0001). Conclusions: This study confirms that children with asthma in Uganda generally have inadequate asthma control, which is attributable to poor asthma management. This could be improved through re-training of medical workers and patient education, and by increasing availability and affordability of essential asthma medications.

scholarly journals Suboptimal Serum 25-Hydroxy-Vitamin D Is Associated with a History of Recent Disease Exacerbation in Pediatric Patients with Bronchial Asthma or Asthma-Suggestive Recurrent Wheezing

2020 ◽  
Vol 17 (18) ◽  
pp. 6545
Author(s):  
Teodora-Irina Adam-Bonci ◽  
Paraschiva Cherecheș-Panța ◽  
Eduard-Alexandru Bonci ◽  
Sorin Claudiu Man ◽  
Ancuța Cutaș-Benedec ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D3 ◽  
Pediatric Asthma ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Disease Exacerbation ◽  
Recurrent Wheezing ◽  
Cross Sectional ◽  
25 Hydroxy Vitamin D ◽  
History Of

Even though vitamin D is widely acknowledged as having a potential immunomodulatory role in asthma, its exact beneficial mechanisms are yet to be clarified. An optimal serum 25-hydroxy-vitamin D (25-OH-VitD) level in pediatric asthma patients might not rely solely on the effect of dose-dependent vitamin D3 intake, but might also be influenced by factors related to insufficient asthma control. We aimed to survey the prevalence of serum 25-OH-VitD deficiency and analyze whether suboptimal levels were associated with asthma severity factors. The current cross-sectional study enrolled 131 pediatric asthma or asthma-suggestive recurrent wheezing patients, for whom serum 25-OH-VitD, IgE, and eosinophil count were assessed. The prevalence of suboptimal serum 25-OH-VitD was 58.8%. A suboptimal vitamin D status was associated with asthma exacerbation in the previous month (p = 0.02). Even under seasonal oral vitamin D3 supplementation, patients with a positive history of asthma attack in the previous four weeks presented significantly lower serum 25-OH-VitD concentrations, compared to their peers with no disease exacerbation. In conclusion, sequential measurements of serum 25-OH-VitD might prove useful for future studies evaluating the dynamic changes in vitamin D3 status in regard to asthma, especially in symptomatic patients.

scholarly journals Vitamin D deficiency in children with bronchial asthma in southern Jordan: a cross-sectional study

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097424
Author(s):  
Enas Al-Zayadneh ◽  
Nedal Awad Alnawaiseh ◽  
Salma Ajarmeh ◽  
Areej Hamed Altarawneh ◽  
Eman M Albataineh ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bronchial Asthma ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Asthma Control Test ◽  
Cross Sectional ◽  
Vitamin D Levels ◽  
25 Oh Vitamin D

Objectives To assess serum 25-hydroxycholecalciferol (25-OH vitamin D) levels in Jordanian children with bronchial asthma, and to examine correlations between 25-OH vitamin D levels and asthma severity and control. Methods A cross-sectional study was conducted at the Paediatric Chest Clinic, Al-Karak Governmental Hospital, Southern Jordan, between May 2015 and February 2016. Serum 25-hydroxyvitamin D level was determined in children aged 1–14 years diagnosed with bronchial asthma (6–14 years) or recurrent wheezing episodes (<6 years). Asthma severity was determined based on the Global Initiative for Asthma assessment, the Asthma Control Test, and the Childhood Asthma Control Test. Demographic and clinical characteristics were compared between patients with low and normal 25-OH vitamin D levels, and correlations between asthma severity and 25-OH vitamin D level were assessed. Results Out of 98 included children, 25-OH vitamin D levels were deficient and insufficient in 41 (41.8%) and 34 (34.7%) children, respectively. Only 23 (23.5%) had sufficient 25-OH vitamin D levels. A significant correlation was found between severity of asthma symptoms and 25-OH vitamin D deficiency. Conclusion 25-OH vitamin D deficiency is highly prevalent in Jordanian children with bronchial asthma and correlates significantly with asthma severity.

Sign in / Sign up

Export Citation Format

Share Document