Near-fatal asthma: clinical and physiologic features, perception of bronchoconstriction, and psychologic profile.
We studied 19 subjects with asthma (11 men and eight women, aged 20 to 66 years), 6 months to 5 years after a near-fatal (NF) episode of asthma (NF group). Mean duration of asthma was 16.3 +/- 2.4 years. On reevaluation, all subjects were using an inhaled beta 2-agonist and inhaled steroids (mean daily dose of budesonide, 1070 micrograms [N = 5], and beclomethasone, 1079 micrograms [N = 14]). Two subjects were taking prednisone, 10 and 15 mg/day. Subjects were matched for age, sex, atopic status, baseline FEV1, and medication use to a control group (C group) of subjects with asthma who had never experienced an NF asthma episode. All subjects had the following evaluation: (1) questionnaire on the characteristics of their asthma, (2) spirometry, (3) morning and evening measurements of peak expiratory flow rates (PEFR) with daily recordings of asthma symptoms for 4 weeks, and (4) psychometric evaluation with the Minnesota Multiphasic Personality Inventory. Ten subjects of the NF group and 13 of the C group had a methacholine challenge with scoring of dyspnea on a modified Borg scale. Mean percent predicted (+/- SEM), FEV1, FVC, and PEFR were similar for the NF and C groups with respective values of 63.4 (4.4), 61.3 (5.6), 81.1 (4.5), 79.1 (3.8), 61.3 (5.6), and 62.4 (6.1). Geometric mean of the provocative concentration of methacholine causing a 20% drop in FEV1 (milligrams per milliliter) was 0.61 for the NF group (N = 10) and 1.18 for the C group (N = 13).(ABSTRACT TRUNCATED AT 250 WORDS)
Boulet
L P
LP
Centre de Pneumologie de l'Hôpital Laval, Université Laval, Sainte-Foy, Quebec, Canada.
Deschesnes
F
F
Turcotte
H
H
Gignac
F
F
D000142:Acidosis, Respiratory / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D000208:Acute Disease; D000328:Adult; D000368:Aged; D001249:Asthma / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D001985:Bronchial Provocation Tests; D016084:Bronchoconstriction; D003643:Death; D005260:Female; D006801:Humans; D008950:MMPI; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D010349:Patient Compliance; D010366:Peak Expiratory Flow Rate / Q000502:physiology; D012121:Respiration, Artificial
D016210:Methacholine Chloride