Why the study?
Do pulmonary function tests predict the need for admission better than arterial blood gases in patients with acute bronchial asthma?
Do pulmonary function tests predict the need for admission better than arterial blood gases in patients with acute bronchial asthma?
Pulmonary function testing is superior to arterial blood gas analysis for predicting the need for admission in acute asthma, suggesting ABGs can be used more selectively to reduce cost and discomfort.
Supports preferring FEV1/PEFR over ABGs for admission decisions in acute asthma; leaves open need for prospective validation before practice change.
Pretreatment and posttreatment arterial blood gas and pulmonary function testing measurements were prospectively compared as to their ability to assess asthma severity accurately and, thus, predict the outcome in 102 episodes of acute bronchial asthma initially seen in the emergency department. The Pao2, Paco2, or pH was unable to separate these patients requiring admission from those that could be confidently discharged, while the 1-s forced expiratory volume (FEV1) and peak expiratory flow rate (PEFR) did so both before and after treatment. Furthermore, virtually all patients with hypercarbia (Paco2 greater than 42 mm Hg) and/or severe hypoxemia (Pao2 less than 60 mm Hg) had a PEFR below 200 L/min, or an FEV1 below 1.0 L. Thus, selective use of arterial blood gas analysis should substantially decrease both diagnostic cost and patient discomfort without jeopardizing health care.
No takes yet. Share an insight, caveat, or question.
Nowak et al. (1983) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: