Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi · 2009
Clinical course and outcome of children with status asthmaticus treated in a pediatric intensive care unit: a 15-year review.
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Chiang Bor Luen, Hsieh Chin Tung, Wang Li Chieh, Lee Jyh Hong, Yu Hsin Hui, Lin Yu Tsan, Yang Yao Hsu
Аннотация
BACKGROUND AND PURPOSE: The purpose of this study was to analyze the clinical course and outcomes of children with status asthmaticus treated in a pediatric intensive care unit (PICU) in Taiwan.
METHODS: The medical charts of all patients aged from 2 to 18 years with status asthmaticus who were admitted to the PICU National Taiwan University Hospital, Taipei, Taiwan, from 1990 to 2006 were reviewed retrospectively.
RESULTS: Twenty eight children were admitted on 33 occasions; 4 patients had more than 1 admission. The mean age was 6.23 years (range, 2-17 years). No control medication was regularly used prior to admission for 81.8% of the episodes. The mean PICU stay was 2.55 days (range, 1-13 days) and, for 78.8% of episodes, the patients were discharged from the ICU within 2 days. For 11 episodes (33.3%), the patients required mechanical ventilation for a mean duration of 3.6 days. The mortality rate was 3.3% (n = 1). Complications included bronchopneumonia (57.6%), hemodynamic compromise (9.1%), neurologic symptoms (6.1%), and air leak (3.3%). Patients requiring mechanical ventilation had significantly lower initial pulse oximeter oxygen saturation (<90%), lower blood gas pH (<7.25), higher partial pressure of carbon dioxide, and longer duration of PICU and hospital stay (p < 0.05) when compared with patients not requiring mechanical ventilation. For patients with a history of repeated PICU admissions for asthma, the intubation rate was 77.7%.
CONCLUSIONS: The prognosis for childhood status asthmaticus is favorable. The most common trigger factors were respiratory tract infection and poor asthma control.
METHODS: The medical charts of all patients aged from 2 to 18 years with status asthmaticus who were admitted to the PICU National Taiwan University Hospital, Taipei, Taiwan, from 1990 to 2006 were reviewed retrospectively.
RESULTS: Twenty eight children were admitted on 33 occasions; 4 patients had more than 1 admission. The mean age was 6.23 years (range, 2-17 years). No control medication was regularly used prior to admission for 81.8% of the episodes. The mean PICU stay was 2.55 days (range, 1-13 days) and, for 78.8% of episodes, the patients were discharged from the ICU within 2 days. For 11 episodes (33.3%), the patients required mechanical ventilation for a mean duration of 3.6 days. The mortality rate was 3.3% (n = 1). Complications included bronchopneumonia (57.6%), hemodynamic compromise (9.1%), neurologic symptoms (6.1%), and air leak (3.3%). Patients requiring mechanical ventilation had significantly lower initial pulse oximeter oxygen saturation (<90%), lower blood gas pH (<7.25), higher partial pressure of carbon dioxide, and longer duration of PICU and hospital stay (p < 0.05) when compared with patients not requiring mechanical ventilation. For patients with a history of repeated PICU admissions for asthma, the intubation rate was 77.7%.
CONCLUSIONS: The prognosis for childhood status asthmaticus is favorable. The most common trigger factors were respiratory tract infection and poor asthma control.