哮喘联盟

   摘要
   目的：评估哮喘急性发作严重性的单次呼吸量（SBC）法在日常生活中已被用于成人急性发作和儿童患者。但单次呼吸量尚未被用于评估儿童的急性发作。研究旨在评估SBC对FEV1百分比（%FEV1）、儿童呼吸功能评估指标（PRAM）（已被验证的急性哮喘严重程度评分）的效标效度与应答。
   方法：计划纳入年龄在7～17岁的急性哮喘发作患者作为受试者。在治疗前和治疗后2小时收集单次呼吸量、%FEV1和PRAM。采用多元线性回归模型评估治疗前SBC与的%FEV1和PRAM之间关系（效标效度）以及这些参数2小时的变化（应答）。采用0.05的双侧α检验，8.5的SBC SD，在每一结果中90%检测的 R大于0.36 ，最小样本量不低于20例。
   结果：从2011年6月至11月，共纳入51例受试者，中位年龄（四分位差）8.46岁（6.92-11.4 岁），男性n=40（78%），非裔美国人n=33（64%）。治疗前，42 例(92%)能够成功完成SBC，24 例（51%）%FEV1。治疗前SBC中位数为16 （10-24）；%FEV1，50 (26-71)；PRAM ,5（1-5）。
   结论：单次呼吸量被证明，采用适度的效标效度可预测治疗前PRAM评分和预测%FEV1的趋势。单次呼吸量似乎对这些标准在急性哮喘严重性上对治疗应答和有限的有效性上没有反应。
 

（苏楠 审校）
Pediatr Emerg Care. 2014 Jan;30(1):8-10. doi: 10.1097/PEC.0000000000000060.

 

Noninvasive bedside assessment of acute asthma severity using single-breath counting.
 

Roofe LR, Resha DJ, Abramo TJ, Arnold DH.
 

Abstract
OBJECTIVE: The single-breath counting (SBC) method for assessment of asthma exacerbation severity has been evaluated in adults during exacerbations and in pediatric patients during routine settings. Single-breath counting has not been evaluated in children during exacerbations. We sought to assess criterion validity and responsiveness of SBC with percent-predicted FEV1 (%FEV1) and the Pediatric Respiratory Assessment Measure (PRAM), a validated acute asthma severity score.
METHODS: We prospectively enrolled subjects aged 7 to 17 years with acute asthma exacerbations. Single-breath counting, %FEV1, and PRAM were obtained before treatment and 2 hours after initiating therapy. Multivariable linear regression models were used to examine associations of pretreatment SBC with %FEV1 and PRAM (criterion validity) and 2-hour change of these measures (responsiveness). With a 2-sided α of 0.05, SBC SD of 8.5, and 90% power to detect an adjusted R of greater than 0.36 for SBC with each outcome measure, a minimum sample of 20 participants was necessary.
RESULTS: From June to November 2011, 51 participants were enrolled, with median (interquartile range) age of 8.46 years (6.92-11.4 years); male sex, n = 40 (78%); and African American race, n = 33 (64%). Before treatment, 42 (92%) were able to successfully perform SBC, and 24 (51%) %FEV1. Median pretreatment SBC obtained was 16 (10-24); %FEV1, 50 (26-71); and PRAM, 5 (1-5).
CONCLUSIONS: Single-breath counting demonstrates modest criterion validity for predicting the pretreatment PRAM score and a trend for predicting %FEV1. Single-breath counting does not appear to be responsive to change of these measures in response to treatment and has limited validity as a measure of acute asthma severity.
 

PediatrEmergCare.2014Jan;30(1):8-10.doi:10.1097/PEC.0000000000000060.