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Long-term outcome after pediatric intensive care unit asthma admissions

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Background:

Patients with asthma admitted to the pediatric intensive care unit (PICU) are often found to have had previous severe asthma exacerbations.

Objective:

To prospectively evaluate the outcome of children after PICU admission.

Methods:

Patients, ages 2‐18 years, admitted to the PICU at Assaf Harofeh Medical Center over a 10-year period were assessed at a mean of 10 years after their admission and compared with matched patients admitted to the pediatric ward. Each patient filled out a questionnaire on subsequent hospitalizations and current asthma treatment and control. Pulmonary function studies and allergy skin tests were performed.

Results:

Compared with patients admitted to the pediatric ward, those admitted to the PICU had more hospitalization and ICU admissions after their index admission (p = 0.022 and p = 0.021, respectively). Most patients in both groups (60‐70%) had uncontrolled asthma, and 47% of those (PICU) and 33% (ward) were not receiving controller therapy. Patients in the PICU group had more recent asthma exacerbations (p = 0.014), weekly wheezing (p = 0.017), and bronchodilator use (p = 0.007). Lung function tests were comparable between the two groups, but 30‐45% in each group had airflow obstruction. No significant differences were found between preschool and school-age children in any of the parameters.

Conclusion:

Compared with patients admitted to the pediatric ward, those admitted to the PICU with asthma exacerbations, experienced more asthma-related hospitalizations and their asthma was less controlled even years later. The lack of regular follow-up and controller therapy in most patients after asthma hospitalization indicated that this increased morbidity might be prevented.
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Keywords: Allergy; PICU; children; control; controller; exacerbations; hospitalization; risk factors

Document Type: Research Article

Affiliations: Pediatric Critical Care Unit, Assaf Harofeh Medical Center, Zerifin, Israel

Publication date: November 1, 2016

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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