[Usefulness of oxygen saturation and peak expiratory flow in the management of acute asthma].
OBJECTIVE
The aim of the present study was to determine the usefulness of oxygen saturation (SaO2) and peak expiratory flow (PEF) in the assessment of severity of acute asthma and the discriminatory quality of their initial values in predicting the patient's hospitalization.


METHODS
A prospective observational design was used. The study was carried out in the Emergency Department (ED) of an urban pediatric hospital with a 1993 census of 170,000 children. One hundred twenty-three children with previously diagnosed asthma, who presented to the ED with wheezing were included in the study. SaO2 and PEF levels were recorded upon arrival at the ED and after receiving initial treatment, prior to deciding the child's discharge or hospitalization. Children were treated according to the current practice guidelines.


RESULTS
The mean SaO2 before and after the treatment was lower for the children who required admission to the hospital, 91.8 +/- 2% and 92.9 +/- 2%, respectively, than for those who were sent home, 96.1 +/- 3.2% and 96.5 +/- 1.8%, respectively (p < 0.01). The same happened with the PEF values, 41.3 +/- 17.8% and 54.8 +/- 17.9% for the admitted patients versus 68.3 +/- 17.9% and 90.1 +/- 10.6% for those sent home. An initial SaO2 of 95% had a sensitivity of 83% and a specificity of 79%. The optimal cut-off point for the PEF was 50%, with a sensitivity and a specificity of 81%.


CONCLUSIONS
Our study shows that SaO2 and PEF can satisfactorily assess the seventy of acute asthma in children and that their initial values can predict the patient's outcome.
Benito Fernández
J
J
Equipo de Urgencias de Pediatría, Hospital de Cruces, Barakaldo Vizcaya.
Mintegui Raso
S
S
Sánchez Echaniz
J
J
Montejo Fernández
M
M
Soto Pedre
E
E
D000208:Acute Disease; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D006801:Humans; D007223:Infant; D008775:Methylprednisolone / Q000627:therapeutic use; D010092:Oximetry; D010100:Oxygen; D010101:Oxygen Consumption; D011241:Prednisone / Q000627:therapeutic use; D011446:Prospective Studies; D012123:Pulmonary Ventilation
D000893:Anti-Inflammatory Agents; D010100:Oxygen; D011241:Prednisone; D008775:Methylprednisolone