[Is it possible to predict the number of nebulizations and the use of intravenous corticosteroid in children with asthma attacks in the emergency room?]
OBJECTIVE: To identify the number of nebulizations needed and the demand for intravenous corticosteroids in children with asthmatic attack, considering clinical and functional characteristics presented at the moment children were admitted to the emergency room. METHODS: We prospectively evaluated 130 children with asthmatic attack and from 1 to 13 years of age. At the moment children were admitted, they were evaluated according to clinical score, arterial oxygen saturation (pulse oximetry), and peak expiratory flow. Next, children received a standard treatment and were observed for the number of consecutive nebulizations required and the use of corticosteroid. Using regression analysis, we assessed the parameters evaluated for a correlation with the number of nebulizations and the use of intravenous corticosteroid. RESULTS: Eighty-eight children (67.7%) received from 1 to 3 nebulizations and 42 children (32.3%), 6 nebulizations. Sixty-eight children (52.3%) received corticosteroid. The initial values for clinical scores, arterial oxygen saturation, and peak expiratory flow showed a significant correlation with the number of nebulizations required and the need for corticosteroids. CONCLUSIONS: According to our results, it is possible to predict and anticipate, at the time chidren are admitted with asthmatic attack, the need for corticosteroid and more nebulizations, which can change the prognosis and the time of evolution of the attack.
Paro
M L
ML
Universidade de São Paulo (USP), SP, Brazil.
Rodrigues
J C
JC