Pediatric asthma--a correlation of clinical treatment and oxygen saturation.

To determine the relationship between changes in room air oxygen saturation (SaO2) and changes in the clinical signs of pediatric asthma patients after treatment with nebulized albuterol, a 9-month prospective observational study was conducted. Eighty-two patients from 2 to 15 years of age who had exacerbations of asthma were studied when they presented to a military community hospital emergency department with an annual census of 62,500. For each patient, the change in SaO2 30 minutes after administration of nebulized albuterol was compared to the change in an ordinal clinical scoring system for asthma. Physicians were blinded to SaO2 measurements. Data are reported as mean values with differences between groups analyzed using the paired t-test. Patients with an initial SaO2 < 95% who clinically improved after treatment had a mean increase in their SaO2 of 2.6%. Patients with an initial SaO2 < 95% who did not clinically improve after treatment had a mean decrease in SaO2 of 1.1%, but this was not statistically significant (p = 0.14). The positive predictive value for improved SaO2 indicating clinical improvement is 98%. Patients with an initial SaO2 > 95% did not have significant changes in SaO2 after treatment regardless of clinical response. For pediatric asthma patients with an initial SaO2 < 95%, increased SaO2 after treatment with inhaled albuterol is predictive of clinical improvement. Patients with an initial SaO2 < 95% who do not have improved SaO2 after treatment require further evaluation.