Page 80 - Škrgat, Sabina, ed. 2022. Severe Asthma - Basic and Clinical Views. Koper: University of Primorska Press. Severe Asthma Forum, 1
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severe asthma forum 1: severe asthma - basic and clinical views Figure 1. Patterns of response to Broncho provocation agent.
or FEV1 PLUS 12% of pre-bronchodilator scan be repeated, and dynamic changes are
value is considered positive. In some cases, used as a support for diagnosis as for appro-
both FVC and FEV1 increase simultaneous- priate treatment. Pre BD spirometric meas-
ly – in those patients we should think about urement should always be used in outpatient
small airway asthma (increase on FVC can be follow-up; BD reversibility can detect degree
due to decrease in air trapping after BD and of current airway inflammation. In latter
consequently more air available for expiration case, exhaled FENO values are valuable in ti-
before airway close during expiration). trating anti-inflammatory treatment.
Conclusions Workplace asthma can be either true oc-
cupational asthma (that developed due to al-
Intrinsic airway disease (smooth muscle and lergens at workplace in a previously non-asth-
epithelial damage due to asthmatic inflam- matic person) or workplace-exacerbated
mation) can be assessed using lung function asthma (usually in known asthmatic due to ir-
measurements. The scope of test differs in re- ritants at workplace – »dirty workplace« asth-
spect of timing and activity of disease process ma). Long-term measurements of flows at
(i.e., methacholine testing is used in stable dis- workplace (electronic PEF) are necessary, best
ease, with normal spirometry; BD test is used in a period on/off place when the patients are
in acute exacerbation, longitudinal PEF meas- symptomatic1.
urements are used in induced-variability envi-
ronments (e.g., workplace)). Since the disease Results of lung function tests should be
is very variable over time and place, most test reproducible. Therefore, standardization of
procedure in lung function lab is necessary.
or FEV1 PLUS 12% of pre-bronchodilator scan be repeated, and dynamic changes are
value is considered positive. In some cases, used as a support for diagnosis as for appro-
both FVC and FEV1 increase simultaneous- priate treatment. Pre BD spirometric meas-
ly – in those patients we should think about urement should always be used in outpatient
small airway asthma (increase on FVC can be follow-up; BD reversibility can detect degree
due to decrease in air trapping after BD and of current airway inflammation. In latter
consequently more air available for expiration case, exhaled FENO values are valuable in ti-
before airway close during expiration). trating anti-inflammatory treatment.
Conclusions Workplace asthma can be either true oc-
cupational asthma (that developed due to al-
Intrinsic airway disease (smooth muscle and lergens at workplace in a previously non-asth-
epithelial damage due to asthmatic inflam- matic person) or workplace-exacerbated
mation) can be assessed using lung function asthma (usually in known asthmatic due to ir-
measurements. The scope of test differs in re- ritants at workplace – »dirty workplace« asth-
spect of timing and activity of disease process ma). Long-term measurements of flows at
(i.e., methacholine testing is used in stable dis- workplace (electronic PEF) are necessary, best
ease, with normal spirometry; BD test is used in a period on/off place when the patients are
in acute exacerbation, longitudinal PEF meas- symptomatic1.
urements are used in induced-variability envi-
ronments (e.g., workplace)). Since the disease Results of lung function tests should be
is very variable over time and place, most test reproducible. Therefore, standardization of
procedure in lung function lab is necessary.
