Disturbances In Arterial Blood Gases Exchanges In Treated Asthmatic Patients

Disturbances in Arterial Blood Gases Exchanges in Treated Asthmatic Patients.

• Authors: Ebrahim Razi, Gh.A. Moussavi

• Institution: Kashan University of Medical Sciences, Kashan, Iran.

Introduction * In asthma, arterial blood gases exchanges is a common findings, that

hypoxemia is the most common form of it. * The mechanism of hypoxemia is ventilation/perfusion mismatch. *The incidence of hypoxemia in attack free asthmatic children is

reported 71% (1). *he mechanism of hypoxemia in asthmatic patients in remission period

is related to hyperaeration and ventilation/perfusion mismatch (2). *If hypoxemia does not manage exactly, it may to be leads to

irreversible obstruction of airways and pulmonary hypertension.

Aim of study

*The aim of this study was evaluation of Arterial Blood Gases exchanges disturbances in referred acute asthmatic patients, seven days after treatment with anti-asthmatic drugs, and comparison the results with normal subjects.

Material & Methods

*The study was carried out on 122 acute asthmatic patients (FEV1 < 60% pred.).

* The results were compared with ABG of 121 normal subjects.

* The patients underwent with routine anti-asthmatic drugs for one week as:

Spray salbutamol 2 puffs QID

Capsule Chromolyn Sodium TDS

Tab. Prdnisone 1mg/kg/day

• All of the patients one week after treatment underwent spirometry and ABG analysis.

Results

Conclusions: In treated asthmatic patients after 7 days of

treatment, hypoxemia is a common complication, which necessitates further supervision and monitoring after the occurrence of acute asthmatic attacks.

• References 1- Wolf B, et al. Hypoxemia in attack free

asthmatic children: relationship with lung volume s and lung mechanics. Bull Eur Physiopathol Respir 1988; 19:471

2- Palmer KNV, et al. Pulmonary function in asthmatic patients in remission. Br Med J 1975; 1: 471

The Effect of Position on Spirometric Values in Obese Asthmatic Patients.

• Authors: Ebrahim Razi, GH.A. Moussavi

• Institution: Kashan University of Medical Sciences, Kashan, Iran.

• Introduction• The obesity as a common health risk is increasing all over

the world. • In obese individuals the effects of increased abdominal fat

tissue might be expected to increase the effects of body position on lung volume (decreased FRC)1.

• In normal obese individuals, body position reported that has not significant differences between sitting and standing position (2).

• In another study that was carried out in massive obese young adults, no differences from predicted vital capacity on change of position were seen (3).

Aim of study The aim of this study was to determine the

effects of body position (standing vs sitting position), in obese asthmatic patients with compared to obese normal subjects.

Material & Methods• The study was conducted on:

49 obese asthmatic patients,

51 obese normal subjects without asthma.

• Obesity was defined as: BMI ≥30 kg/ m2

• Spirometry was performed with Fukuda spirometer (ST 95), according to ERS recommendation.

• In both groups the spirometry was performed alternately in standing and sitting position.

• Comparison of mean values of the differences between two groups of subjects in sitting and standing position was determined, using Mann-Whitney test and paired t test.

• p value ≤ 5% was considered significant.

• Calculation of “change percent” was down as below formula:

(Sitting value – standing value) / sitting value × 100

Conclusions• Spirometric values in obese asthmatic

patients with BMI ≥30 kg/ m2 in compared with normal obese subjects is not affected by the position.

References

1. Tucher, D. H., and H. O. Sieker. 1960. The effect of change in body position on lung volumes and intrapulmonary gas mixing in patients with obesity, heart failure and emphysema. Am. Rev. Respir. Dis. 1960; 82: 787

2- Gudmundsson G, et al. Spirometric values in obese individuals. Effects of body position.

Am J Respir Crit Care Med. 1997 Sep; 156(3 Pt 1):998. 3. Ray, C. S., et al. Effects of obesity on respiratory function. Am. Rev.

Respir. Dis. 1983; 128: 501