BCV may be set to one of the treatments of asthma exacerbation in children

Abstract

Asthma is a common disease in children and severe exacerbation can be life-threatening. Although it is enough outpatient treatment for mild-to-moderate exacerbations, severe exacerbations are generally required hospitalization. When a patient’s respiratory condition gets worse and fell into acute respiratory failure (ARF), mechanical ventilation is needed. We reported the efficiency of BCV for inpatients’ ARF and avoided intubation or non-invasive positive pressure ventilation at this Conference. This time, we focused “outpatients with exacerbations”. We treated with BCV in addition to inhalation of beta2 stimulant and intravenous steroids, bronchodilator for them. BCV (Continuous negative mode) was treated with severe exacerbation and BCV (Secretion clearance mode) was treated with mild exacerbation. BCV could improve their respiratory condition and avoid their hospitalization. Method: This study was analyzed the clinical data of outpatients with exacerbations visited Okada Children’s Clinic from Oct. 2010 to Aug. 2011. There were 130 patients (0.9% of total outpatients) treated with BCV (Continuous Negative mode). In 5 serious cases, their respiratory conditions were compared before and after BCV. To evaluate their respiratory conditions, we use Modified Pulmonary Index Score (mPI score, Annals of Allergy, and immunology. 2005; 94: 355–59) and electronic stethoscope by 3MTM Littmann Electronic Stethoscope Model 3200, Zargis Medical. In mPI score, 6 categories were evaluated: oxygen saturation, accessory muscle use, inspiratory to expiratory flow ratio, degree of wheezing, heart rate, and respiratory rate. Electronic Stethoscope could record and analyze their lung sound. Result: Even if they were diagnosed severe exacerbations, mPI score was improved from an average of 12 points to 7 points and their lung sound was improved by BCV in addition to inhalation therapy and intravenous drip treatment. Conclusion: BCV is simple and easy to be set, and can be judged the effect in a short time. We think BCV is useful for outpatient treatment. As a result, most of children with severe exacerbations could avoid hospitalization. It allayed their family’s burden and reduced our medical expenses. We recommend BCV is set to one of the treatments of asthma exacerbation in children.