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Long term outcome of ventilated asthmatics
1Respiratory Unit, Alder Hey Children's Hospital, Liverpool.
Archives of Disease in Childhood
|December 1, 1990
Summary
Severe asthma attacks requiring mechanical ventilation (intermittent positive pressure ventilation/IPPV) in children are concerning. Survivors face ongoing asthma symptoms and a high risk of future mortality.
Area of Science:
- Pediatric Pulmonology
- Critical Care Medicine
Background:
- Acute severe asthma necessitates mechanical ventilation in a subset of pediatric patients.
- Intermittent positive pressure ventilation (IPPV) is employed for acute asthma exacerbations.
Purpose of the Study:
- To assess the long-term outcomes and mortality associated with IPPV in children with acute severe asthma.
Main Methods:
- Retrospective analysis of 48 IPPV episodes in 31 asthmatic children over 25 years (1971-1989).
- Follow-up assessments included symptom evaluation, pulmonary function tests (PFTs), and histamine challenge (PC20).
Main Results:
- Eight deaths occurred during IPPV; three additional deaths occurred post-discharge.
- Of 17 children followed up long-term, 16 experienced persistent asthma symptoms, with over half reporting daily symptoms.
- Pulmonary function tests showed reduced FEV1 (83% predicted) and airway hyperresponsiveness (geometric mean PC20 2.1 mg/ml).
Conclusions:
- IPPV is still required for a small number of children with severe asthma annually.
- Children requiring IPPV for asthma represent a high-risk group with significant long-term morbidity and mortality.