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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Pediatric asthma admissions: chronic severity and acute exacerbations
Arnon Elizur1, Leonard B Bacharier, Robert C Strunk
1Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO 63110, USA. elizur_a@kids.wustl.edu
Summary
Asthma exacerbations leading to intensive care unit (ICU) admission are not clearly understood. This study found that acute asthma severity, not chronic severity, predicted ICU admission, and systemic corticosteroids were underused.
Area of Science:
- Pediatric Pulmonology
- Critical Care Medicine
Background:
- Asthma exacerbations are a common reason for pediatric hospital admissions.
- Factors influencing intensive care unit (ICU) admission for severe asthma attacks are not well-defined.
Purpose of the Study:
- To compare characteristics of pediatric patients admitted to the ICU versus a general pediatric ward for asthma exacerbations.
- To identify factors associated with ICU admission for asthma exacerbations.
Main Methods:
- Retrospective chart review of 56 pediatric patients admitted to the ICU for asthma exacerbations.
- Comparison with 56 age-, sex-, race-, and era-matched pediatric patients admitted to a general ward for asthma.
- Analysis of pre-admission treatment, including oral steroid use.
Main Results:
- Children admitted to the ICU and general ward had comparable chronic asthma severities.
- Acute exacerbation severity, not chronic asthma severity, appeared to influence ICU admission.
- A low proportion of patients in both groups received oral steroids prior to admission.
Conclusions:
- Acute asthma exacerbation severity is a key factor in ICU admissions, independent of chronic asthma severity.
- Systemic corticosteroid under-treatment is prevalent in pediatric asthma exacerbations requiring hospitalization.
- Further research into optimal management strategies for severe pediatric asthma exacerbations is warranted.
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