title: Transient expiratory flow interruptions (TEFI) increase expiratory flow in acute asthma exacerbation.
abstract: We have shown that expiratory flows increase when expirations are rapidly interrupted in stable asthmatic patients. We hypothesized that a similar increase could be obtained in patients with acute exacerbation of bronchial asthma treated in the Emergency Room. A total of 30 asthmatic patients were randomly allocated into two groups, the study and the control groups. Patients in the study group were connected to a device with an inspiratory line designed to administer pressurized aerosols. The expiratory line passed through a valve completely interrupting flow at 4 Hz, with an open/closed time ratio of 10/3. The control group patients were also connected to the device, but with the valve kept open. Mean expiratory flow at tidal volume (MEFTV) was measured under basal conditions and at 4, 8 and 12 minutes after connecting the patients to the device. All patients received standard treatment throughout the procedure. At all time points MEFTV increased more in the study than in the control group (p < 0.003 by two-way ANOVA). There was no residual effect after disconnection from the device. We conclude that TEFI can rapidly improve expiratory flows in patients with acute exacerbations of asthma, while pharmacologic interventions proceed.
authors.affiliation: Servicio de Neumonología, Hospital Posadas, El Palomar, Buenos Aires.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Fernández
authors.forename: Sergio
authors.initials: S
authors.lastname: Guardia
authors.forename: Alejandra
authors.initials: A
authors.lastname: González
authors.forename: Roberto
authors.initials: R
authors.lastname: Serrano
authors.forename: Daniel
authors.initials: D
authors.lastname: Rodenstein
authors.forename: Hernando
authors.initials: H
authors.lastname: Sala
mesh_terms: D000208:Acute Disease; D000328:Adult; D000420:Albuterol / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D019819:Budesonide / Q000008:administration & dosage; D005260:Female; D005540:Forced Expiratory Flow Rates / Q000502:physiology*; D006801:Humans; D009241:Ipratropium / Q000008:administration & dosage; D008297:Male; D013997:Time Factors
chemical_list: D001993:Bronchodilator Agents; D019819:Budesonide; D009241:Ipratropium; D000420:Albuterol