EVALUATION OF PRETREATMENT AND POSTTREATMENT PULSE OXIMETRY IN ACUTE CHILDHOOD ASTHMA

Objectives: To evaluate the utility of pre- and posttreatment O-2 satu ration (SpO(2)) for prediction of admission or relapse after ED releas e in acute asthma exacerbations using a standardized treatment protoco l. Design: A prospective, double-blind, observational study was perfor med at a pediatric ED. Children with acute asthma were enrolled upon E D presentation. SpO(2) was measured prior to treatment and after dispo sition decision. Two experienced physicians determined disposition bas ed on history and physical examination alone, while blinded to SpO(2). Relapse of released patients was determined by telephone follow-up. R esults: A pretreatment room-air SpO(2) of less than or equal to 91% ha d a sensitivity of 0.24, a specificity of 0.86, and a likelihood ratio of 1.77 to predict admission/relapse. A posttreatment room-air SpO(2) of less than or equal to 91% had a sensitivity of 0.34, a specificity of 0.98, and a likelihood ratio of 16.43 to predict admission/relapse . Conclusions: As opposed to some previous studies, this study found p retreatment SpO(2) to be a relatively poor predictor of admission. A p osttreatment SpO(2) of less than or equal to 91% occurred in a minorit y (32%) of patients, but increased the odds of admission 16-fold and m ay be used as an adjunct to objectively confirm the need for admission .