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J Pediatr. 2004 Nov;145(5):641-5.

Oxygen saturation as a predictor of prolonged, frequent bronchodilator therapy in children with acute asthma.

Author information

1
Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Canada.

Erratum in

  • J Pediatr. 2004 Dec;145(6):864.

Abstract

OBJECTIVES:

To examine if the initial oxygen saturation (SaO2) in the Emergency Department is a useful predictor of prolonged frequent bronchodilator therapy (FBT) in children with acute asthma.

STUDY DESIGN:

Prospective cohort study of 273 children, 1 to 17 years of age, requiring systemic corticosteroids. Patients were categorized as needing FBT for >4 hours (n=166) versus >4 hours (n=107) and >12 hours (n=79) versus >12 hours (n=194). Multiple logistic regression determined the association between SaO2 and these outcomes.

RESULTS:

Baseline SaO2 remains a significant independent predictor of FBT for >4 hours (OR=0.81) and >12 hours (OR=0.84); 91% of patients with SaO2 of 90% to 91% had FBT >4 hours and 80% of patients with SaO2 of < or =89% had FBT >12 hours. Children with SaO2 of < or =91% are 14.7 and 12.0 times more likely to require FBT for >4 hours and >12 hours, respectively, than those with SaO2 of 98% to 100%. The interval likelihood ratios for FBT >4 hours were 12.3 for SaO2 of < or =89%, 6.5 for 90% to 91%, but only 1.8 for 92% to 93%. The likelihood ratios for FBT >12 hours decreased from 9.8 for SaO2 of < or =89% to 3.5 for SaO2 of 90% to 91%.

CONCLUSIONS:

SaO2 is a useful predictor of FBT >4 hours if it is < or =91% and of FBT >12 hours if it is < or =89%.

PMID:
15520765
DOI:
10.1016/j.jpeds.2004.06.072
[Indexed for MEDLINE]

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