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Use of pulse oximetry in the hospital management of acute asthma in childhood

Use of pulse oximetry in the hospital management of acute asthma in childhood
Use of pulse oximetry in the hospital management of acute asthma in childhood

Oxyhemoglobin saturation values were recorded before and 10 minutes after 5 mg of nebulized salbutamol in 75 children (age, 1.5–14.6 years) admitted to hospital with acute asthma. Other assessments included heart rate, respiratory rate, peak expiratory flow rate, pulsus paradoxus, and an asthma severity score. All assessments were performed by the same observer (GC) and subsequent hospital care was transferred to the on‐call pediatricians, who were not told the initial saturation values. Six children required intravenous therapy after hospital admission when their symptoms were not improved after nebulized salbutamol. Cutoff points for each continuous variable were selected so that they identified at least 5 of these 6 children (i.e., with a sensitivity of at least 83 percent). The resulting specificities and positive predictive values were calculated for each variable before and after nebulized therapy. A postnebulizer saturation of less than 91 % had a sensitivity of 100% [95% confidence interval (CI), (54–1001 with a specificity of 98%] (95% CI, 92–100) and a positive predictive value of 86%. This was the best predictor of the need for intravenous (IV) therapy. Correlation coefficients were calculated for the 75 admissions and 2 others who required immediate IV treatment to determine how closely saturation values were related to the other recorded clinical variables. Saturation values were significantly, though weakly, correlated with asthma severity scores and prenebulizer heart rate, but they were not associated with any of the other variables. These results highlight the difficulties encountered when assessing acute asthma in a hospital population with a large number of preschool children. Saturation measurements are easy to obtain in all age groups and help identify those children who require intensive therapy and close supervision after hospital admission. © 1993 Wiley‐Liss, Inc.

correlation with clinical findings, Predictors of IV treatment, sensitivity, specificity
8755-6863
345-349
Connett, G.J.
55d5676c-90d8-46bf-a508-62eded276516
Lenney, W.
6f3a5624-186a-4181-825e-41cc0adbc55f
Connett, G.J.
55d5676c-90d8-46bf-a508-62eded276516
Lenney, W.
6f3a5624-186a-4181-825e-41cc0adbc55f

Connett, G.J. and Lenney, W. (1993) Use of pulse oximetry in the hospital management of acute asthma in childhood. Pediatric Pulmonology, 15 (6), 345-349. (doi:10.1002/ppul.1950150606).

Record type: Article

Abstract

Oxyhemoglobin saturation values were recorded before and 10 minutes after 5 mg of nebulized salbutamol in 75 children (age, 1.5–14.6 years) admitted to hospital with acute asthma. Other assessments included heart rate, respiratory rate, peak expiratory flow rate, pulsus paradoxus, and an asthma severity score. All assessments were performed by the same observer (GC) and subsequent hospital care was transferred to the on‐call pediatricians, who were not told the initial saturation values. Six children required intravenous therapy after hospital admission when their symptoms were not improved after nebulized salbutamol. Cutoff points for each continuous variable were selected so that they identified at least 5 of these 6 children (i.e., with a sensitivity of at least 83 percent). The resulting specificities and positive predictive values were calculated for each variable before and after nebulized therapy. A postnebulizer saturation of less than 91 % had a sensitivity of 100% [95% confidence interval (CI), (54–1001 with a specificity of 98%] (95% CI, 92–100) and a positive predictive value of 86%. This was the best predictor of the need for intravenous (IV) therapy. Correlation coefficients were calculated for the 75 admissions and 2 others who required immediate IV treatment to determine how closely saturation values were related to the other recorded clinical variables. Saturation values were significantly, though weakly, correlated with asthma severity scores and prenebulizer heart rate, but they were not associated with any of the other variables. These results highlight the difficulties encountered when assessing acute asthma in a hospital population with a large number of preschool children. Saturation measurements are easy to obtain in all age groups and help identify those children who require intensive therapy and close supervision after hospital admission. © 1993 Wiley‐Liss, Inc.

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More information

Published date: June 1993
Keywords: correlation with clinical findings, Predictors of IV treatment, sensitivity, specificity

Identifiers

Local EPrints ID: 420672
URI: https://eprints.soton.ac.uk/id/eprint/420672
ISSN: 8755-6863
PURE UUID: 32e46f49-3871-49f4-84ab-5de6f4ad1967
ORCID for G.J. Connett: ORCID iD orcid.org/0000-0003-1310-3239

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Date deposited: 11 May 2018 16:30
Last modified: 14 Mar 2019 01:22

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Author: G.J. Connett ORCID iD
Author: W. Lenney

University divisions

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