Article
Children's perception of breathlessness in acute asthma
I Male, H Richter, P Seddon
Royal
Alexandra Children's Hospital, Brighton, UK
Correspondence to: Dr I Male, Chailey Heritage Clinical Services, Beggars Wood Road, North Chailey, E Sussex, UK
Accepted 22 May 2000
AIM
To determine whether asthmatic
children who present to hospital with hypoxia perceive breathlessness
less well than non-hypoxic presenters.
METHODSA total of 27 children aged
5-16 years (mean age 10) admitted with acute asthma had recordings of
oxygen saturation (SaO2), clinical score,
forced expiratory volume in one second (FEV1), and
breathlessness score (HMP) at admission and at 5, 10, 24, 48, and 72 hours after admission. Those defined as hypoxic
(SaO2 <92%) at admission were compared with a
non-hypoxic group.
RESULTSTwelve children were
hypoxic at admission. Compared with the non-hypoxic group they were
younger (8.6 (SD 2.8) v 11.2 (2.8) y,
p = 0.02), and had greater airway obstruction (FEV1 32.5 (10)% v 54.3 (26)%, p = 0.0073, 95%
confidence interval (CI) 
36.9 to 6.6) yet had a trend towards
less breathlessness (median HMP 4 v 3, p = 0.062, CI 0.001 to 2.00) at admission. The hypoxic group had a
smaller change in breathlessness from admission to discharge, despite a
similar improvement in FEV1, reflected in a lower ratio of
change in HMP to change in FEV1
(
HMP/FEV1) (median HMP/FEV1
0.021%
1 v
0.073%1, p = 0.0081, CI 0.075 to 0.016). Linear
regression analysis showed a strong relation between
HMP/FEV1 and initial SaO2
(p = 0.004, r = 0.54).
CONCLUSIONSAsthmatic children who
present to hospital hypoxic tend to perceive themselves as less
breathless than non-hypoxic children. This may predispose to a future
life threatening attack.
Keywords: asthma; perception of breathlessness
© 2000 by Archives of Disease in Childhood
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