Prevalence and risk factors of lactic acidosis in children with acute moderate and severe asthma, a prospective observational study
| Autor: | Jean-Yves Pauchard, Marta Ruman-Colombier, Mario Gehri, Ermindo R. Di Paolo, Isabelle Rochat Guignard |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Salbutamol Anion gap Ipratropium bromide 03 medical and health sciences 0302 clinical medicine Internal medicine Bronchodilator Hyperventilation medicine Asthma business.industry Lactic acidosis Paediatrics medicine.disease respiratory tract diseases 030228 respiratory system Pediatrics Perinatology and Child Health Acidosis Lactic/chemically induced Acidosis Lactic/epidemiology Adolescent Albuterol Asthma/complications Asthma/epidemiology Child Child Preschool Humans Prevalence Risk Factors Hyperlactatemia Original Article medicine.symptom business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | European Journal of Pediatrics European journal of pediatrics, vol. 180, no. 4, pp. 1125-1131 |
| ISSN: | 1432-1076 0340-6199 |
| Popis: | Lactic acidosis is a common complication of status asthmaticus in adults. However, data is sparse in children. The aim of this study was to describe the prevalence and risk factors for lactic acidosis in children hospitalised for acute moderate or severe asthma. A total of 154 children 2–17 years of age were enrolled in a prospective observational study conducted in a tertiary hospital. All had capillary blood gas assessment 4 h after the first dose of salbutamol in hospital. The primary endpoint was the prevalence of lactic acidosis. Potential contributing factors such as age, sex, BMI, initial degree of asthma severity, type of salbutamol administration (nebuliser or inhaler), steroids, ipratropium bromide, and glucose-containing maintenance fluid represented secondary endpoints. All in all, 87% of patients had hyperlactatemia (lactate concentration > 2.2 mmol/l). Lactic acidosis (lactate concentration > 5 mmol/l and anion gap ≥ 16 mmol/l) was observed in 26%. In multivariate analysis, age more than 6 years (OR = 2.8, 95% CI 1.2–6.6), glycemia above 11 mmol/l (OR = 3.2 95% CI 1.4–7.4), and salbutamol administered by nebuliser (OR = 10, 95% CI 2.7–47) were identified as risk factors for lactic acidosis in children with moderate or severe asthma.Conclusion: Lactic acidosis is a frequent and early complication of acute moderate or severe asthma in children. What is Known:• Lactic acidosis during acute asthma is associated with b2-mimetics administration.• Salbutamol-related lactic acidosis is self-limited but important to recognise, as compensatory hyperventilation of lactic acidosis can be mistaken for respiratory worsening and lead to inappropriate supplemental bronchodilator administration.What is New:• Lactic acidosis is a frequent complication of acute asthma in the paediatric population.• Age older than 6 years, hyperglycaemia, and nebulised salbutamol are risk factors for lactic acidosis during asthma. |
| Databáze: | OpenAIRE |
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