title: Quantitative end-tidal carbon dioxide in acute exacerbations of asthma.
abstract: OBJECTIVE
  To examine quantitative end-tidal carbon dioxide (ETCO(2)) in children with acute exacerbations of asthma. We hypothesize that quantitative ETCO(2) will be lower in children during an acute exacerbation of asthma and will correlate with the severity of the exacerbation. We also hypothesize that ETCO(2) can be successfully performed in all groups in the setting of a pediatric emergency department.
  
  
  METHODS
  Patients with acute exacerbation of asthma (n = 86) and control subjects without respiratory or metabolic disturbances (n = 88) were prospectively enrolled in a pediatric emergency department. A physical examination, vital signs, and ETCO(2) measurements were performed on arrival and, in the patients with asthma, after each bronchodilator treatment.
  
  
  RESULTS
  ETCO(2) was measured successfully in 97% of enrolled children. After adjusting for respiratory rate, ETCO(2) was significantly lower in patients with acute exacerbation of asthma than in control subjects (P < .001). ETCO(2) measured after the first and after the final bronchodilator treatment were significantly associated with the number of bronchodilator treatments received and with hospital admission (P < or = .002).
  
  
  CONCLUSIONS
  ETCO(2) can be successfully measured in all children and is significantly lower in children with acute exacerbations of asthma compared with healthy control subjects. Quantitative ETCO(2) may be an objective, noninvasive, and effort-independent way to assess the severity of asthma.
authors.affiliation: Yale University School of Medicine and the Department of Pediatrics, Section of Pediatric Emergency Medicine, Yale-New Haven Children's Hospital, New Haven, CT 06520, USA. Melissa.Langhan@yale.edu
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Langhan
authors.forename: Mark R
authors.initials: MR
authors.lastname: Zonfrillo
authors.forename: David M
authors.initials: DM
authors.lastname: Spiro
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000378:metabolism* / Q000503:physiopathology; D002245:Carbon Dioxide / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies
chemical_list: D002245:Carbon Dioxide