Outcome of children with life-threatening asthma necessitating pediatric intensive care

• Main Authors: Cheung Kam-Lau (Author), Leung Ting-Fan (Author), Tang Wing-Sum (Author), Hon Kam-Lun (Author), Ng Pak-Cheung (Author)
• Format: Book
• Published: BMC, 2010-07-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/1824-7288-36-47; 1720-8424; 1824-7288
• Keywords: Pediatrics; RJ1-570
• Source: Italian Journal of Pediatrics, Vol 36, Iss 1, p 47 (2010)

<p>Abstract</p> <p>Objective</p> <p>To report the outcome of children with life-threatening asthma (LTA) admitted to a university Pediatric Intensive Care Unit (PICU).</p> <p>Methods</p> <p>Retrospective study between October 2002 and May 2010 was carried out. Every child with LTA and bronchospasm was included.</p> <p>Results</p> <p>30 admissions of 28 patients (13 M, 17 F) were identified which accounted for 3% of total PICU admissions (n = 1033) over the study period. The majority of patients were toddlers (median age 3.1 years). Few had past history of prematurity, lung diseases, or neuro-developmental conditions. Approximately half had previous admissions for asthma and one-forth with history of non-compliance to recommended treatment for asthma. One patient had parainfluenza virus and one had rhinovirus isolated. None of these factors were associated with need for mechanical ventilation (n = 6 admissions). Comparing with patients who did not receive mechanical ventilation, ventilated children had significantly higher PIM2 score (1.65 versus 0.4, p < 0.001), higher PCO₂levels (9.3 kPa versus 5.1 kPa, p = 0.01) and longer PICU stay (median 2.5 days versus 2 days, <it>p </it>= 0.03) The majority of patients received systemic corticosteroids, intravenous or inhaled bronchodilators. There was one pneumothorax but no death in this series.</p> <p>Conclusions</p> <p>LTA accounted for a small percentage of PICU admissions. Previous hospital admissions for asthma and history of non-compliance were common. Approximately one quarters required ventilatory supports. Regardless of the need for mechanical ventilation, all patients survived with prompt treatment.</p>