Ortiz Aldana I, Arreguín Osuna L, García Caballero R
Servicio de Alergia, Instituto Nacional de Pediatría, México, DF.
Rev Alerg Mex. 1997 Nov-Dec;44(6):158-61.
Asthmatic crisis is one of the most frequent urgencies in children. One of the most difficult decision for a physician is to determine what patient requires only ambulatory treatment and what patient needs hospital treatment. Many investigators have developed predictive scores, but to date conclusions are confusing. The purpose of the present study was to compare the value of arterial oxygen saturation versus peak expiratory flow rate measurements as predictors of the outcome of the asthmatic crisis in children. We performed a prospective, longitudinal, observational, comparative study in 50 children (30 males, 20 female), with ages between 6 and 18 years old, with the presence of a moderate asthmatic crisis. We measured arterial oxygen saturation and peak expiratory flow rate at the moment of their arrival to urgencies and at 30 minutes, 2, 4 and 24 hours after the administration of nebulized albuterol (100 mcg/k/dose). We found significant differences on baseline arterial oxygen saturation and the registrations taken at 2, 4, and 24 hours posttreatment (0.01), and we could only find significant differences between baseline peak expiratory flow rate and the registrations taken at 24 hours pretreatment. In conclusion arterial oxygen saturation is a better predictor than peak expiratory flow rate in the evolution of the asthmatic crisis in children.
哮喘危象是儿童最常见的急症之一。对医生来说,最困难的决定之一是确定哪些患者仅需门诊治疗,哪些患者需要住院治疗。许多研究人员已经开发出预测评分,但迄今为止结论并不明确。本研究的目的是比较动脉血氧饱和度与呼气峰值流速测量值作为儿童哮喘危象预后预测指标的价值。我们对50名年龄在6至18岁之间、患有中度哮喘危象的儿童(30名男性,20名女性)进行了一项前瞻性、纵向、观察性、对比研究。在他们到达急症室时以及雾化吸入沙丁胺醇(100 mcg/k/剂量)后30分钟、2小时、4小时和24小时,我们测量了动脉血氧饱和度和呼气峰值流速。我们发现基线动脉血氧饱和度与治疗后2小时、4小时和24小时的测量值之间存在显著差异(P = 0.01),并且我们仅发现基线呼气峰值流速与治疗前24小时的测量值之间存在显著差异。总之,在儿童哮喘危象的演变过程中,动脉血氧饱和度比呼气峰值流速是更好的预测指标。