Fatores preditivos da evolução da asma aguda em crianças

Abstract

Objective: To use clinical and functional characteristics observed upon admission to an emergency room to identify factors predictive of the occurrence and course of acute asthma attacks in children. Methods: We prospectively studied 130 asthmatic children, from 1 to 13 years of age, who were treated for acute asthma attacks in an emergency room, evaluating status determined at admission and over the course of the crisis. Clinical scores were determined and arterial oxygen saturation by pulse oximetry was measured, as was peak expiratory flow. Results: The initial clinical score, arterial oxygen saturation by pulse oximetry and peak expiratory flow correlated with the number of inhalations performed, as well as with the need for corticosteroid treatment. Mean initial clinical score and mean arterial oxygen saturation by pulse oximetry of the hospitalized patients were statistically different from those of patients who were not hospitalized. Initial clinical score, arterial oxygen saturation and prior treatment for the same exacerbation were predictive of the need for hospitalization. Conclusion: The measurement of arterial oxygen saturation by pulse oximetry and the clinical score were useful in predicting the occurrence and course of acute asthma attacks in children. The measurement and interpretation of peak expiratory flow is difficult in children and, under these conditions, served no practical application.

Pico de fluxo expiratório: é melhor medir!

“…Contradicting this conclusion, we found the recent report by Paro and Rodrigues, (6) who evaluated 130 children from one to thirteen years of age with acute asthma in São Paulo. Studying predictive factors of hospital admissions due to asthma, these authors reported that arterial oxygen saturation and clinical scores obtained at the beginning of the emergency treatment were useful but found that PEF measurement did not contribute to predicting hospitalization.…”

Use of magnesium sulfate in continuous infusion in patients with severe acute asthma, in a pediatric emergency room

“…The variables evaluated were age, sex, weight, height, serum magnesium dosage, presence of adverse events, presence of pneumonia, use of antibiotics, clinical evolution through the modified Wood–Downes severity score (Figure 1). The outcomes analyzed were length of stay in the pediatric emergency, need for admission to a pediatric ward or pediatric ICU (PICU), use of ventilatory support and death 20,21 …”