Clinical course and outcome of children with status asthmaticus treated in a pediatric intensive care unit: A 15-year review
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
42
Journal Issue
6
Pages
488-493
Date Issued
2009
Author(s)
Abstract
Background and purpose: The purpose of this study was to analyze the clinical course and outcomes of children with status asthmaticus treated in a pediatric intensive care unit (PICU) in Taiwan. Methods: The medical charts of all patients aged from 2 to 18 years with status asthmaticus who were admitted to the PICU National Taiwan University Hospital, Taipei, Taiwan, from 1990 to 2006 were reviewed retrospectively. Results: Twenty eight children were admitted on 33 occasions; 4 patients had more than 1 admission. The mean age was 6.23 years (range, 2-17 years). No control medication was regularly used prior to admission for 81.8% of the episodes. The mean PICU stay was 2.55 days (range, 1-13 days) and, for 78.8% of episodes, the patients were discharged from the ICU within 2 days. For 11 episodes (33.3%), the patients required mechanical ventilation for a mean duration of 3.6 days. The mortality rate was 3.3% (n = 1). Complications included bronchopneumonia (57.6%), hemodynamic compromise (9.1%), neurologic symptoms (6.1%), and air leak (3.3%). Patients requiring mechanical ventilation had significantly lower initial pulse oximeter oxygen saturation (<90%), lower blood gas pH (<7.25), higher partial pressure of carbon dioxide, and longer duration of PICU and hospital stay (p < 0.05) when compared with patients not requiring mechanical ventilation. For patients with a history of repeated PICU admissions for asthma, the intubation rate was 77.7%. Conclusions: The prognosis for childhood status asthmaticus is favorable. The most common trigger factors were respiratory tract infection and poor asthma control. ? 2009 Journal of Microbiology, Immunology and Infection.
SDGs
Other Subjects
aminophylline; azithromycin; beta 2 adrenergic receptor stimulating agent; corticosteroid; ipratropium bromide; antiasthmatic agent; adolescent; article; artificial ventilation; asthmatic state; blood carbon dioxide tension; blood pH; bronchopneumonia; cardiovascular disease; child; clinical article; controlled study; disease course; female; hospitalization; human; intensive care unit; length of stay; male; medical record review; mortality; neurologic disease; oxygen saturation; preschool child; respiratory tract infection; retrospective study; school child; Taiwan; treatment outcome; age; asthmatic state; nonparametric test; recurrent disease; season; sex difference; statistics; Taiwan; Adolescent; Age Factors; Anti-Asthmatic Agents; Child; Child, Preschool; Female; Hospital Mortality; Humans; Intensive Care Units, Pediatric; Length of Stay; Male; Recurrence; Respiration, Artificial; Retrospective Studies; Seasons; Sex Factors; Statistics, Nonparametric; Status Asthmaticus; Taiwan; Treatment Outcome
Type
journal article