Use of peak expiratory flow for assessing bronchodilator responsiveness

Aggarwal, Ashutosh N.; Agarwal, Ritesh; Gupta, Dheeraj; Jindal, Surinder K.

doi:10.3132/pcrj.2008.00064

Cited by 3 publications

(2 citation statements)

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“…[114116117] PEF and change in PEF also cannot be used as a surrogate for standard spirometric criteria for bronchodilator reversibility assessment. [118] Although PEF has been used for the diagnosis, monitoring and prognostication in COPD, the supporting evidence is weak. [115119120]…”

Section: Introductionmentioning

confidence: 99%

Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations

et al. 2013

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Chronic obstructive pulmonary disease (COPD) is a major public health problem in India. Although several International guidelines for diagnosis and management of COPD are available, yet there are lot of gaps in recognition and management of COPD in India due to vast differences in availability and affordability of healthcare facilities across the country. The Indian Chest Society (ICS) and the National College of Chest Physicians (NCCP) of India have joined hands to come out with these evidence-based guidelines to help the physicians at all levels of healthcare to diagnose and manage COPD in a scientific manner. Besides the International literature, the Indian studies were specifically analyzed to arrive at simple and practical recommendations. The evidence is presented under these five headings: (a) definitions, epidemiology, and disease burden; (b) disease assessment and diagnosis; (c) pharmacologic management of stable COPD; (d) management of acute exacerbations; and (e) nonpharmacologic and preventive measures. The modified grade system was used for classifying the quality of evidence as 1, 2, 3, or usual practice point (UPP). The strength of recommendation was graded as A or B depending upon the level of evidence.

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Section: Introductionmentioning

confidence: 99%

Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations

et al. 2013

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“…[ 98 ] Although changes in PEF following bronchodilator administration correlates with changes in FEV 1 , the sensitivity is poor. [ 99 ] Hence, demonstration of airway obstruction as well as bronchodilator reversibility is preferably done with spirometry.…”

Section: Diagnosis Of Asthmamentioning

confidence: 99%

Guidelines for diagnosis and management of bronchial asthma: Joint ICS/NCCP (I) recommendations

et al. 2015

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High altitude pulmonary edema among "Amarnath Yatris"

et al. 2013

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Background:Annual pilgrimage (Yatra) to the cave shrine of Shri Amarnath Ji’ is a holy ritual among the Hindu devotees of Lord Shiva. Located in the Himalayan Mountain Range (altitude 13,000 ft) in south Kashmir, the shrine is visited by thousands of devotees and altitude sickness is reportedly common.Materials and Methods:More than 600,000 pilgrims visited the cave shrine in 2011 and 2012 with 239 recorded deaths. Thirty one patients with suspected altitude sickness were referred from medical centers en-route the cave to Sher-i-Kashmir Institute of Medical Sciences, a tertiary-care center in capital Srinagar (5,000 ft). The clinical features and the response to treatment were recorded.Results:Thirty-one patients (all lowlanders, 19 male; age 18-60 years, median 41) had presented with acute onset breathlessness of 1-4 days (median 1.9 d) starting within 12-24 h of a rapid ascent; accompanied by cough (68%), headache (8%), dizziness and nausea (65%). Sixteen patients had associated encephalopathy. Clinical features on admission included tachypnea (n = 31), tachycardia (n = 23), bilateral chest rales (n = 29), cyanosis (n = 22) and grade 2-4 encephalopathy. Hypoxemia was demonstrable in 24 cases and bilateral infiltrates on radiologic imaging in 29. Ten patients had evidence of high-altitude cerebral edema. All patients were managed with oxygen, steroids, nifedipine, sildenafil and other supportive measures including invasive ventilation (n = 3). Three patients died due to multiorgan dysfunction.Conclusions:Altitude sickness is common among Amaranath Yatris from the plains and appropriate educational strategies should be invoked for prevention and prompt treatment.

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Use of peak expiratory flow for assessing bronchodilator responsiveness

Cited by 3 publications

References 5 publications

Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations

Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations

Guidelines for diagnosis and management of bronchial asthma: Joint ICS/NCCP (I) recommendations

High altitude pulmonary edema among "Amarnath Yatris"

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