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Pulse oximetry and peak flow as indicators of wheezing severity in children and improvement following bronchodilator treatments

  • Loren G. Yamamoto
    Correspondence
    Address reprint requests to Dr Yamamoto, Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, 1319 Punahou St, Honolulu, HI 96826.
    Affiliations
    Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.

    Emergency Services, Kapiolani Medical Center For Women and Children, Honolulu, HI, USA.
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  • Robert A. Wiebe
    Affiliations
    Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.

    Emergency Services, Kapiolani Medical Center For Women and Children, Honolulu, HI, USA.
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  • Carlos Anaya
    Affiliations
    Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.

    Emergency Services, Kapiolani Medical Center For Women and Children, Honolulu, HI, USA.
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  • Rupert K.S. Chang
    Affiliations
    Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.

    Emergency Services, Kapiolani Medical Center For Women and Children, Honolulu, HI, USA.
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  • Melanie A. Chang
    Affiliations
    Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.

    Emergency Services, Kapiolani Medical Center For Women and Children, Honolulu, HI, USA.
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  • Alan M. Terada
    Affiliations
    Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.

    Emergency Services, Kapiolani Medical Center For Women and Children, Honolulu, HI, USA.
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  • Michele L. Bray
    Affiliations
    Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.

    Emergency Services, Kapiolani Medical Center For Women and Children, Honolulu, HI, USA.
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  • Colleen Y. Ching
    Affiliations
    Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.

    Emergency Services, Kapiolani Medical Center For Women and Children, Honolulu, HI, USA.
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  • Mavis Y. Kim
    Affiliations
    Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.

    Emergency Services, Kapiolani Medical Center For Women and Children, Honolulu, HI, USA.
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  • Elaine T. Shinsato
    Affiliations
    Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.

    Emergency Services, Kapiolani Medical Center For Women and Children, Honolulu, HI, USA.
    Search for articles by this author
  • Lori L. Shomura
    Affiliations
    Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.

    Emergency Services, Kapiolani Medical Center For Women and Children, Honolulu, HI, USA.
    Search for articles by this author
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      Abstract

      This study examined the changes from the initial peak flows and oxygen saturations (OSAT) of wheezing children at presentation to the emergency department through their treatment in the emergency department. Data was collected prospectively on 785 patients 5 to 20 years of age during an 11-month period from November 1, 1990, to September 30, 1991. Both the initial OSAT and peak flows were correlated with the number of bronchodilator treatments required in the emergency department and with the need for hospitalization. Both the initial OSAT and the peak flows had a limited ability to predict the need for hospitalization. Oxygen saturation appears to be a valid measure of wheezing severity and is more easily obtained in children of all ages. Following bronchodilator treatment, peak flow results in a larger quantitative improvement than OSAT; however, this difference does not appear to have any significant advantage. Aerosolized albuterol and subcutaneous epinephrine resulted in a similar degree of improvement as measured by peak flow and by oxygen saturation, with clinically similar changes in heart rate.

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