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Clinical characteristics and factors associated with mucus plugs under bronchoscopy in children hospitalized for
Peng Han1, Anxia Jiao2, Ju Yin1
1Respiratory Department, Beijing Children's Hospital, China National Clinical Research Center of Respiratory Diseases, National Center for Children's Health, Capital Medical University, Beijing, China.
Insights
Mucus plugs in hospitalized children with asthma are linked to first-time diagnosis, breathing difficulties, and cesarean birth. These factors help identify children at higher risk for mucus plugs during acute asthma attacks.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
Background:
- Acute asthma attacks in children can be complicated by mucus plugs, impacting treatment and outcomes.
- Understanding the clinical characteristics and associated factors of mucus plugs is crucial for effective management.
Purpose of the Study:
- To describe the clinical characteristics of hospitalized children experiencing acute asthma attacks with mucus plugs.
- To investigate factors associated with the presence of mucus plugs in pediatric asthma patients.
Main Methods:
- A retrospective study analyzed 242 hospitalized children and adolescents with acute asthma attacks (2016-2021).
- Bronchoalveolar lavage results categorized subjects into mucus plug and control groups.
- Logistic regression analysis identified factors associated with mucus plugs.
Main Results:
- The mucus plug group showed higher proportions of dyspnea (52.6% vs. 26.8%) and first-time asthma diagnosis (87.4% vs. 76.8%).
- Lower serum total IgE levels were observed in the mucus plug group.
- First-time asthma diagnosis (OR=4.404), dyspnea (OR=4.039), and cesarean birth (OR=0.274) were associated with mucus plugs.
Conclusions:
- Clinical features in children with asthma and mucus plugs differ from those without.
- First-time asthma diagnosis, dyspnea, and cesarean birth are potential factors associated with mucus plugs in pediatric asthma hospitalizations.
Objective:
To describe clinical characteristics of hospitalized children with acute asthma attacks complicated with mucus plugs and to investigate the factors associated with mucus plugs in asthma children.
Methods:
This retrospective study analyzed hospitalized children and adolescents with acute asthma attacks from January 2016 to December 2021. The demographic information and characteristics were collected. Subjects were categorized into the mucus plug group and the control group based on the bronchoalveolar lavage results. The Logistic regression analyses were utilized to assess the relative factors associated with mucus plugs. All data were analyzed using SPSS 22.0.
Results:
This study included 242 individuals. Out of the 151 subjects who underwent bronchoscopy, 62.9% were classified in the mucus plug group and 37.1% in the control group. The subjects with dyspnea had a higher proportion in the mucus plug group (52.6% vs. 26.8%). The serum total IgE level of the mucus plug group was lower than the control group. The proportion of subjects who were diagnosed with asthma for the first time during hospitalization (87.4% vs. 76.8%) and combined with respiratory infection (91.6% vs. 82.1%) in the mucus plug group might be higher than that in the control group. More subjects in the mucus plug group were administered systemic glucocorticoid, magnesium sulfate, aminophylline, and mucolytic drugs after hospitalization. In multivariable analysis, diagnosed with asthma for the first time during hospitalization (OR = 4.404; 1.101-17.614), dyspnea (OR = 4.039; 1.306-12.496), and cesarean (OR = 0.274; 0.092-0.812) might be associated with mucus plug in children hospitalized for an acute asthma attack.
Suggests:
While our retrospective study suggests that some clinical features of children hospitalized with asthma who have mucus plugs differ from those without, further studies are required.
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