Abstract
Background
Status asthmaticus (SA) is a common reason for admission to the pediatric emergency
department (ED). Assessing asthma severity efficiently in the ED can be challenging
for clinicians. Adjunctive tools for the clinician have demonstrated inconsistent
results. Studies have shown that pulsus paradoxus (PP) correlates with asthma severity.
Pleth Variability Index (PVI) is a surrogate measure of PP.
Objective
We investigated whether PVI at triage correlates with disposition from the ED.
Methods
We recruited children aged 2–18 years old who presented to the pediatric ED of a tertiary
care children's hospital with SA. PVI, Respiratory Severity Score, and vital signs
were documented at triage and 2 hours into each patient's ED stay. PVI was measured
using the Masimo Radical-7® monitor (Masimo Corp., Irvine, CA).
Results
Thirty-eight patients were recruited. Twenty-seven patients were discharged home,
10 patients were admitted to the general pediatrics floor and 1 patient was admitted
to the intensive care unit. PVI values at triage did not correlate with disposition
from the ED (p = 0.63). Additionally, when trending the change in PVI after 2 hours of therapy in
the ED, no statistically significant patterns were demonstrated.
Conclusions
Our study did not demonstrate a correlation between PVI and clinical course for asthmatics.
PVI may be more clinically relevant in sicker children. Furthermore, it is possible
that continuous monitoring of PVI may demonstrate more unique trends in relation to
asthma severity versus single values of PVI. Additional studies are necessary to help
clarify the relationship between PVI and the clinical course of children with SA.
Keywords
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Article info
Publication history
Published online: July 06, 2018
Accepted:
April 27,
2018
Received in revised form:
March 2,
2018
Received:
June 15,
2017
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
