Abstract
Few studies are available concerning correlations between pulse oximetry and peak expiratory flow in children and adolescents with acute asthma. Although the Global Initiative for Asthma states that measurements of lung function and oximetry are critical for the assessment of patients, it is not clear if both methods should necessarily be included in their evaluation. Since there is a significant difference in cost between pulse oximetry equipment and peak expiratory flow devices, we determined whether clinical findings and peak expiratory flow measurements are sufficient to determine the severity of acute asthma. The present prospective observational study was carried out to determine if there is correlation between pulse oximetry and peak expiratory flow determination in 196 patients with acute asthma aged 4 to 15 years diagnosed according to the Global Initiative for Asthma criteria. Patients experiencing their first or second wheezing episode, with fever, related acute or chronic diseases, and unable to perform the peak expiratory flow maneuver were excluded. Measurements of peak expiratory flow and pulse oximetry were performed at admission and after 15 min of each inhaled salbutamol cycle. Correlations obtained by linear regression using the Pearson correlation coefficients (r) were 0.41 (P < 0.0001), 0.53 (P < 0.0001), 0.51 (P < 0.0001), and 0.61 (P < 0.0001) at admission and after the first, second and third cycles of salbutamol, respectively. These correlations showed that one measure cannot substitute the other (Pearson's coefficient <0.7), probably because they evaluate different aspects in the airways, suggesting that peak expiratory flow should not be used alone in the assessment of acute asthma in children and adolescents.
Highlights
Clinical findings are usually insufficient to properly determine the severity of acute asthma [1,2,3,4,5,6,7,8,9]
The Global Initiative for Asthma states that measurements of lung function and oximetry are critical for the assessment of patients, it is not clear if both methods should necessarily be included in their evaluation
Since there is a significant difference in cost between pulse oximetry equipment and peak expiratory flow devices, we determined whether clinical findings and peak expiratory flow measurements are sufficient to determine the severity of acute asthma
Summary
Clinical findings are usually insufficient to properly determine the severity of acute asthma [1,2,3,4,5,6,7,8,9]. The Global Initiative for Asthma (GINA) states that measurements of lung function and oximetry are critical for patient assessment [10], it is not clear whether both methods should be included in the evaluation of acute asthma, since no critical comparison of the two measurements has been done. Since there is a significant difference in costs between SpO2 equipment and PEF devices, with SpO2 being about 20 times more expensive, it seems reasonable to determine whether clinical findings and PEF measurements are sufficient to assess the severity of acute asthma. The objective of the present study was to determine the correlation between SpO2 and PEF in children and adolescents with acute asthma in order to determine whether SpO2, the more expensive procedure, could be avoided in the evaluation of exacerbations. The answer may be relevant in low-income countries, where the two measurements are not performed routinely in emergency departments
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