Relation between pulse oximetry and clinical score in children with acute wheezing less than 24 months of age

The aim of this study was to determine the relation between transcutaneous hemoglobin oxygen saturation, measured by pulse oximetry (SpO(2)), and clinical score values in 138 infants (mean +/- SD, 6.6 +/- 5.5 months of age) with acute wheezing episodes presenting in a primary care outpatient setting. A single investigator evaluated the severity of the acute wheezing episodes by assigning a clinical score and was unaware of the SpO(2) values. Another investigator measured SpO(2) values on all subjects. The mean (+/- SD) SpO(2) value was 98.2 +/- 1.1% for children with clinical scores of 2-5 (n = 32); 95.4 +/- 1.5% for those with scores of 6-7 (n = 82), and 92.9 +/- 2% for children with scores of 8-10 (n = 24), (P < 0.001 by Bonferroni's multiple comparison, when all two-way comparisons were done for each pair of results). The clinical score showed a good correlation with SpO(2) (r = -0.76; 95% CI, -0.83 to -0.68). We conclude that if pulse oximetry is not available, it is advisable to include oxygen in the therapy of wheezy infants with clinical scores values greater than or equal to 8. Pediatr Pulmonol, 1999; 27:423-427, (C) 1999 Wiley-Liss, Inc.