title: Pulse oximetry and peak flow as indicators of wheezing severity in children and improvement following bronchodilator treatments.
abstract: This study examined the changes from the initial peak flows and oxygen saturations (OSAT) of wheezing children at presentation to the emergency department through their treatment in the emergency department. Data was collected prospectively on 785 patients 5 to 20 years of age during an 11-month period from November 1, 1990, to September 30, 1991. Both the initial OSAT and peak flows were correlated with the number of bronchodilator treatments required in the emergency department and with the need for hospitalization. Both the initial OSAT and the peak flows had a limited ability to predict the need for hospitalization. Oxygen saturation appears to be a valid measure of wheezing severity and is more easily obtained in children of all ages. Following bronchodilator treatment, peak flow results in a larger quantitative improvement than OSAT; however, this difference does not appear to have any significant advantage. Aerosolized albuterol and subcutaneous epinephrine resulted in a similar degree of improvement as measured by peak flow and by oxygen saturation, with clinically similar changes in heart rate.
authors.affiliation: Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu 96826.
authors.forename: L G
authors.initials: LG
authors.lastname: Yamamoto
authors.forename: R A
authors.initials: RA
authors.lastname: Wiebe
authors.forename: C
authors.initials: C
authors.lastname: Anaya
authors.forename: R K
authors.initials: RK
authors.lastname: Chang
authors.forename: M A
authors.initials: MA
authors.lastname: Chang
authors.forename: A M
authors.initials: AM
authors.lastname: Terada
authors.forename: M L
authors.initials: ML
authors.lastname: Bray
authors.forename: C Y
authors.initials: CY
authors.lastname: Ching
authors.forename: M Y
authors.initials: MY
authors.lastname: Kim
authors.forename: E T
authors.initials: ET
authors.lastname: Shinsato
mesh_terms: D000293:Adolescent; D000328:Adult; D000336:Aerosols; D000420:Albuterol / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002648:Child; D004636:Emergency Service, Hospital; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006339:Heart Rate; D006760:Hospitalization; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D010092:Oximetry; D010366:Peak Expiratory Flow Rate; D012135:Respiratory Sounds / Q000145:classification / Q000503:physiopathology*; D012720:Severity of Illness Index
chemical_list: D000336:Aerosols; D001993:Bronchodilator Agents; D000420:Albuterol; D004837:Epinephrine