Can Peak Expiratory Flow Measurements Differentiate Chronic Obstructive Pulmonary Disease from Congestive Heart Failure英文文献资料.docVIP

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Can Peak Expiratory Flow Measurements Differentiate Chronic Obstructive Pulmonary Disease from Congestive Heart Failure英文文献资料.doc

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Can Peak Expiratory Flow Measurements Differentiate Chronic Obstructive Pulmonary Disease from Congestive Heart Failure英文文献资料

HindawiPublishingCorporation EmergencyMedicineInternational Volume2012,ArticleID912570,3pages doi:10.1155/2012/912570 ClinicalStudy CanPeakExpiratoryFlowMeasurementsDifferentiateChronic ObstructivePulmonaryDiseasefromCongestiveHeartFailure? JohnE.GoughandKoriL.Brewer DepartmentofEmergencyMedicine,BrodySchoolofMedicine,Greenville,NC27834,USA CorrespondenceshouldbeaddressedtoJohnE.Gough,goughj@ Received13August2011;Accepted30August2011 AcademicEditor:StephenH.Thomas Copyright?2012J.E.GoughandK.L.Brewer. This is an open access article distributed under the Creative Commons AttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkis properlycited. DyspneicpatientsarecommonlyencounteredbyEmergencyMedicalService(EMS).FrequentcausesincludeChronicObstructive PulmonaryDisease(COPD)andCongestiveHeartFailure(CHF).Measurementofpeakexpiratory?owrate(PEFR)hasbeen proposedtohelpdi?erentiateCOPDfromCHF.Thisprospective,cohort,pilotstudywasconductedtodetermineifPEFRin patientswithanexacerbationofCOPDweresigni?cantlydi?erentthanCHF.Includedwerepatientspresentingwithdyspnea plusahistoryofCOPDand/orCHF.APEFRwasmeasured,valueswerecomparedtopredictedaverage,andapercentagewas calculated.Twenty-onepatientswereenrolled.SixhadadiagnosisofCOPD,12CHF;3hadotherdiagnoses.Meanpercentageof predictedPEFRwithCOPDwas26.36%,CHF48.9%(P = 0.04).PatientspresentingwithacuteCOPDhadsigni?cantlylower percentageofpredictedPEFRthanthosewithCHF.TheseresultssuggestthatPEFRmaybeusefulindi?erentiatingCOPDfrom CHF.Thisstudyshouldbeexpandedtotheprehospitalsettingwithalargernumberofsubjects. 1.Introduction promise in assessing COPD [4, 5]. Peak expiratory ?ow is notpartofthestandardprotocolforgaugingCHFpatients, although several studies have suggested that PEFR may be useful in helping to di?erentiate cardiac from pulmonary causesofdyspnea[3,5].Thepurposeofthisstudyistodeter- mineifpeakexpiratory?owmetersaree?ectiveinassisting EMS personnel in di?erentiatin