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Original Contribution
April 15, 1983

Arterial Blood Gases and Pulmonary Function Testing in Acute Bronchial Asthma: Predicting Patient Outcomes

Author Affiliations

From the Divisions of Emergency Medicine (Drs Nowak, Tomlanovich, and Sarkar), Pulmonary Medicine (Dr Kvale), and Allergy and Immunology (Dr Anderson), Henry Ford Hospital, Detroit.

JAMA. 1983;249(15):2043-2046. doi:10.1001/jama.1983.03330390047030

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 >42 mm Hg) and/or severe hypoxemia (Pao2 <60 mm Hg) had a PEFR below 200 L/min, or an FEV, 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.

(JAMA 1983;249:2043-2046)

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