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Pulsus paradoxus in childhood asthma--its prognostic value
Insights
Pulsus paradoxus in children with asthma indicates severity and predicts treatment response. This sign, a drop in pulse during breathing, helps assess acute asthma exacerbations.
Area of Science:
- Pediatric Pulmonology
- Cardiovascular Physiology
Background:
- Asthma exacerbations in children can present with respiratory distress.
- Pulsus paradoxus is a known clinical sign in severe respiratory conditions.
Purpose of the Study:
- To investigate the presence and significance of pulsus paradoxus in asthmatic children.
- To correlate pulsus paradoxus with asthma severity and treatment outcomes.
Main Methods:
- One hundred asthmatic children were assessed for pulsus paradoxus using a sphygmomanometer.
- Systolic pressure differences during inspiration and expiration were recorded.
- Response to epinephrine treatment was documented.
Main Results:
- Seventy-five children with mild asthma showed no pulsus paradoxus and responded well to epinephrine.
- Twenty-five children had palpable pulsus paradoxus (10-30 mm Hg).
- Higher pulsus paradoxus (≥20 mm Hg) correlated with hospitalization for status asthmaticus.
Conclusions:
- Pulsus paradoxus is a valuable indicator of acute asthma exacerbation severity in children.
- The degree of pulsus paradoxus correlates with clinical severity and response to bronchodilators.
- This sign aids in clinical decision-making for pediatric asthma management.
Abstract:
One hundred asthmatic children were examined for pulsus paradoxus, a palpable diminution or obliteration of the peripheral pulse during inspiration, while in bronchospasm. Pulsus was measured with a sphygmomanometer and the difference in systolic pressure between inspiration and expiration was noted. Seventy-five children with mild asthma had no palpable pulsus and responded with complete subsidence of symptoms with one or two injections of aqueous epinephrine, 1-1000. Twenty-five children had palpable pulsus ranging from 10 mm to 30 mm. Five patients with pulsus between 10 and 15 mm were admitted to the hospital with status asthmaticus and pneumonia; eight other patients responded to parenteral epinephrine. Twelve children had pulsus of 20 mm or greater and all were hospitalized for uncomplicated status asthmaticus. Pulsus paradoxus may be found in acute exacerbation of childhood asthma and its degree correlates with both the severity and response to bronchodilating agents.