Children with severe acute asthma admitted to Dutch PICUs: A changing landscape

Autor: Boeschoten, S.A., Buysse, C.M., Merkus, P.J.F.M., Wijngaarden, J.M.C. van, Heisterkamp, S.G.J., Jongste, J.C. de, Rosmalen, J. van, Otter, S.C.M., Lemson, J., Boehmer, A.L.M., Hoog, M. de
Přispěvatelé: Pediatric surgery, AII - Inflammatory diseases, ACS - Diabetes & metabolism, Paediatric Intensive Care, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Pediatric Surgery, Pediatrics, Epidemiology
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Pulmonary and Respiratory Medicine
Pediatrics
medicine.medical_specialty
Adolescent
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
Intensive Care Units
Pediatric
medicine.disease_cause
Original Article: Asthma
steroid‐naïve
03 medical and health sciences
0302 clinical medicine
status asthmaticus
030225 pediatrics
Intensive care
medicine
Cannula
Humans
Albuterol
Child
Referral and Consultation
Netherlands
Retrospective Studies
intensive care
Asthma
Pediatric intensive care unit
business.industry
Mortality rate
Retrospective cohort study
Original Articles
medicine.disease
Bronchodilator Agents
Hospitalization
lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]
severe acute asthma
030228 respiratory system
Child
Preschool
Acute Disease
Pediatrics
Perinatology and Child Health
Salbutamol
Administration
Intravenous
Female
business
Nasal cannula
pediatric asthma
Severe acute asthma
medicine.drug
Zdroj: Pediatric Pulmonology, 53(7), 857-865. Wiley-Liss Inc.
Pediatric Pulmonology, 53, 857-865
Pediatric pulmonology, 53(7), 857-865. Wiley-Liss Inc.
Pediatric Pulmonology, 53(7), 857-865. Wiley
on behalf of SKIC Dutch collaborative PICU research network 2018, ' Children with severe acute asthma admitted to Dutch PICUs: A changing landscape ', Pediatric Pulmonology, vol. 53, no. 7, pp. 857-865 . https://doi.org/10.1002/ppul.24009
Pediatric Pulmonology, 53, 7, pp. 857-865
Pediatric Pulmonology
ISSN: 8755-6863
Popis: Contains fulltext : 193193.pdf (Publisher’s version ) (Open Access) The number of children requiring pediatric intensive care unit (PICU) admission for severe acute asthma (SAA) around the world has increased. OBJECTIVES: We investigated whether this trend in SAA PICU admissions is present in the Netherlands. METHODS: A multicenter retrospective cohort study across all tertiary care PICUs in the Netherlands. Inclusion criteria were children (2-18 years) hospitalized for SAA between 2003 and 2013. Data included demographic data, asthma diagnosis, treatment, and mortality. RESULTS: In the 11-year study period 590 children (660 admissions) were admitted to a PICU with a threefold increase in the number of admissions per year over time. The severity of SAA seemed unchanged, based on the first blood gas, length of stay and mortality rate (0.6%). More children received highflow nasal cannula (P < 0.001) and fewer children needed invasive ventilation (P < 0.001). In 58% of the patients the maximal intravenous (IV) salbutamol infusion rate during PICU admission was 1 mcg/kg/min. However, the number of patients treated with IV salbutamol in the referring hospitals increased significantly over time (P = 0.005). The proportion of steroid-naive patients increased from 35% to 54% (P = 0.004), with a significant increase in both age groups (2-4 years [P = 0.026] and 5-17 years [P = 0.036]). CONCLUSIONS: The number of children requiring PICU admission for SAA in the Netherlands has increased. We speculate that this threefold increase is explained by an increasing number of steroid-naive children, in conjunction with a lowered threshold for PICU admission, possibly caused by earlier use of salbutamol IV in the referring hospitals.
Databáze: OpenAIRE
Externí odkaz: