PMID- 30945478
OWN - NLM
STAT- MEDLINE
DCOM- 20200312
LR  - 20200312
IS  - 1099-0496 (Electronic)
IS  - 1099-0496 (Linking)
VI  - 54
IP  - 7
DP  - 2019 Jul
TI  - Randomized clinical trial of high concentration versus titrated oxygen use in 
      pediatric asthma.
PG  - 970-976
LID - 10.1002/ppul.24329 [doi]
AB  - OBJECTIVE: To compare the effects of high concentration to titrated oxygen 
      therapy (HCOT) on transcutaneous carbon dioxide (PtCO(2) ) level in pediatric 
      asthma exacerbation. Titrated oxygen therapy (TOT) in acute asthma will avoid a 
      rise in PtCO (2) in the pediatric population. METHOD: The study design is a 
      prospective, randomized, clinical trial comparing HCOT (maintain SpO2 92-95%) 
      while being treated for asthma exacerbation in the emergency department (ED). 
      INCLUSION CRITERIA: 2 to 18 years, previously diagnosed asthma with acute 
      exacerbation (asthma score >5). PtCO(2) and asthma scores were measured at 0, 20, 
      40, 60 minutes and then every 30 minutes until disposition decision. The primary 
      outcome was a change in PtCO (2) . Secondary outcomes were admission rate and 
      change in asthma score. RESULTS: A total of 96 patients were enrolled in the 
      study with a mean age of 8.27 years; 49 in HCOT and 47 in the TOT group. The 
      0 minute PtCO(2) was similar (35.33 + 3.88 HCOT vs 36.66 + 4.69 TOT, P = 0.13); 
      whereas, the 60 minutes PtCO (2) was higher in the HCOT (38.08 + 5.11 HCOT vs 
      35.51 + 4.57 TOT, P = 0.01). The asthma score was similar at 0 minute 
      (7.55 + 1.34 HCOT vs 7.30 + 1.18 TOT, P = 0.33); whereas, the 60 minutes asthma 
      score was lower in the TOT (4.71 + 1.38 HCOT vs 3.57 + 1.25 TOT, P = 0.0001). The 
      rate of admission to the hospital was 40.5% in HCOT vs 25.5% in the TOT 
      (P = 0.088). CONCLUSIONS: HCOT in pediatric asthma exacerbation leads to 
      significantly higher carbon dioxide levels, which increases asthma scores and 
      trends towards the increasing rate of admission. Larger studies are needed to 
      explore this association.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Patel, Bhavi
AU  - Patel B
AUID- ORCID: 0000-0002-9776-2719
AD  - Department of Pediatric Critical Care, The Children's Hospital at Montefiore, 
      Bronx, New York.
AD  - Department of Pediatric Cardiac Critical Care, Nicklaus Children's Hospital, 
      Miami, Florida.
FAU - Khine, Hnin
AU  - Khine H
AD  - Department of Pediatric Critical Care, The Children's Hospital at Montefiore, 
      Bronx, New York.
FAU - Shah, Ami
AU  - Shah A
AD  - Department of Pediatric Critical Care, The Children's Hospital at Montefiore, 
      Bronx, New York.
FAU - Sung, Deborah
AU  - Sung D
AD  - Department of Pediatric Critical Care, The Children's Hospital at Montefiore, 
      Bronx, New York.
FAU - Medar, Shivanand
AU  - Medar S
AD  - Department of Pediatric Critical Care, The Children's Hospital at Montefiore, 
      Bronx, New York.
FAU - Singer, Lewis
AU  - Singer L
AD  - Department of Pediatric Critical Care, The Children's Hospital at Montefiore, 
      Bronx, New York.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20190403
PL  - United States
TA  - Pediatr Pulmonol
JT  - Pediatric pulmonology
JID - 8510590
RN  - 142M471B3J (Carbon Dioxide)
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Adolescent
MH  - Asthma/metabolism/*therapy
MH  - Carbon Dioxide/*metabolism
MH  - Child
MH  - Child, Preschool
MH  - Emergency Service, Hospital
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Oxygen/*administration & dosage
MH  - *Oxygen Inhalation Therapy
OTO - NOTNLM
OT  - asthma
OT  - oxygen
OT  - pediatric asthma exacerbation
OT  - transcutaneous carbon dioxide (PtCO2)
EDAT- 2019/04/05 06:00
MHDA- 2020/03/13 06:00
CRDT- 2019/04/05 06:00
PHST- 2018/04/13 00:00 [received]
PHST- 2019/01/23 00:00 [revised]
PHST- 2019/03/13 00:00 [accepted]
PHST- 2019/04/05 06:00 [pubmed]
PHST- 2020/03/13 06:00 [medline]
PHST- 2019/04/05 06:00 [entrez]
AID - 10.1002/ppul.24329 [doi]
PST - ppublish
SO  - Pediatr Pulmonol. 2019 Jul;54(7):970-976. doi: 10.1002/ppul.24329. Epub 2019 Apr 
      3.