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Pulse oximetry and peak expiratory flow rate correlations in acute asthma exacerbation in children
Uchenna Chinweokwu Onubogu1, A Ayuk2
1Department of Paediatrics and Child Health, Rivers State University Teaching Hospital, 5-6 Harley Street, Old GRA, Port Harcourt, River State, Nigeria.
Insights
Oxygen saturation (SpO2) and peak expiratory flow rate (PEFR) have a moderate correlation in children with mild asthma exacerbations. SpO2 levels below 95% indicate a higher likelihood of acute asthma exacerbation in children.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Asthma Research
Background:
- The relationship between oxygen saturation (SpO2) and peak expiratory flow rate (PEFR) in acute asthma is variable.
- Accurate assessment is crucial for timely intervention in pediatric asthma exacerbations.
Purpose of the Study:
- To evaluate the predictive value and correlation of SpO2 and PEFR in identifying children with mild asthma exacerbations.
- To define the role of SpO2 and PEFR in guiding early intervention decisions for pediatric asthma.
Main Methods:
- Retrospective review of pediatric asthma patient data from a Nigerian tertiary center (April 2014 - February 2020).
- Analysis of biodata, medical history, clinical status, baseline SpO2, and %predicted PEFR.
- Statistical analysis including correlation and odds ratio calculations.
Main Results:
- Children with mild asthma exacerbations had lower SpO2 (96 ± 2.6%) and %predicted PEFR (64.1 ± 23) compared to asymptomatic children.
- A moderate correlation (r = 0.44, P = 0.04) was found between SpO2 and %predicted PEFR in children with mild exacerbations.
- SpO2 levels between 92%-95% significantly increased the likelihood of mild asthma exacerbation (OR: 2.52).
Conclusions:
- SpO2 <95% is associated with a higher likelihood of acute asthma exacerbation in children.
- SpO2 and PEFR play a limited role in identifying mild asthma exacerbations due to moderate to poor correlation.
- Further research may refine the utility of these parameters in asthma management.
Background:
The relationship between oxygen saturation (SpO2) and peak expiratory flow rate (PEFR) in patients with acute asthma is variable.
Aim:
This study aims to assess the predictive value and correlation of this relationship in identifying children with mild symptoms of asthma exacerbation and defining their role in guiding early intervention decision-making.
Patients And Methods:
This was a retrospective review of the register of children with asthma seen at the respiratory clinic of a tertiary center in Nigeria from April 2014 to February 2020. Information on their biodata, medical history, clinical status, baseline SPO2, and %predicted PEFR was retrieved and analyzed.
Results:
The mean values for participants with no symptoms and those with mild symptoms of asthma exacerbation were respectively: SpO2 was 97 ± 1.6% and 96 ± 2.6% (MD: 1.2; 95% CI; 0.7-1.7, P < 0.001); %predicted PEFR: 77.8 ± 17.8 and 64.1 ± 23 (MD; 13.68; 95% CI; 7.3 to 20.0, P < 0.001). Among those with uncontrolled asthma who were having mild symptom exacerbation of their asthma, the correlation between SpO2 and %predicted PEFR was significantly moderate (r = 0.44, P = 0.04). Children with SpO2 between the range of 92%-95% were significantly more likely to have mild symptoms of asthma exacerbation (OR: 2.52,95% CI: 1.22, 5.2, P = 0.01) compared to those with SpO2 >95%.
Conclusion:
Children with SpO2 of <95% are more likely to have an acute asthma exacerbation. While SpO2 and PEFR have more role in identifying children without acute asthma exacerbation and a limited role in identifying children with mild symptoms of asthma due to their exacerbation due to their moderate to poor correlation.
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