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Status Asthmaticus

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https://www.readbyqxmd.com/read/29664873/effects-of-a-picu-status-asthmaticus-de-escalation-pathway-on-length-of-stay-and-albuterol-use
#1
Steven Brennan, Lia Lowrie, Jamie Wooldridge
OBJECTIVES: Evaluate the effects of an asthma de-escalation clinical pathway on selected outcomes for patients admitted to a PICU with status asthmaticus. DESIGN: Time series quality improvement trial. SETTING: PICU in a tertiary care children's hospital. PATIENTS: Children age 2-18 years old with a known diagnosis of asthma presenting with status asthmaticus. INTERVENTION: One-hundred five admissions to a PICU for status asthmaticus were treated according to a new de-escalation pathway between August 15, 2015, and August 30, 2016...
April 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29660840/the-effectiveness-of-magnesium-sulfate-for-status-asthmaticus-outside-the-intensive-care-setting
#2
Ryan L DeSanti, Nisha Agasthya, Krystal Hunter, Mohammed J Hussain
AIM: Magnesium is an adjunctive therapy used in patients with status asthmaticus who do not respond to conventional therapy. The optimal time from initiation of therapy, to determination of response and administration of magnesium has not yet been resolved. Our objective was to determine if magnesium administered in the non-intensive care setting can decrease duration of continuous albuterol and hospital length of stay. METHODS: We performed a retrospective cohort analysis of children ages 2-18 years admitted to the pediatric unit on continuous albuterol between January 2014 and December 2015 in a tertiary care children's hospital...
April 16, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29577091/early-administration-of-venovenous-extracorporeal-life-support-for-status-asthmaticus-during-anaesthetic-induction-case-report-and-literature-review
#3
Won Ho Chang
Here we report a case of a 40-year-old man who visited the emergency room with severe chest pain. He showed a Stanford type B aortic dissection on chest-computed tomography. Despite medical treatment and malperfusion of lower extremities, acute renal failure developed; hence thoracic endovascular aortic repair (TEVAR) was considered under general anaesthesia. After endotracheal intubation, ventilation with low tidal volume required high inspiratory airway pressure. An arterial blood gas analysis showed PaCO2 of 61...
2018: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29548908/asthma-related-mortality-in-the-united-states-of-america-1999-2015-a-multiple-causes-of-death-analysis
#4
Vijay Kodadhala, Jennifer Obi, Priscilla Wessly, Alem Mehari, R F Gillum
BACKGROUND: Asthma mortality based on the underlying cause of death (UCOD) underestimates disease burden. OBJECTIVE: Therefore, in this study, asthma mortality in the US 1999-2015 was analyzed, as well as the pattern of reporting of asthma and its co-morbidities in death certificates, using multiple-cause of death (MCOD) records. METHODS: All 156,517 death certificates with any mention of asthma were analyzed for 1999-2015. Asthma was defined by ICD-10 code J45 based either on the UCOD or MCOD...
March 13, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29440128/a-quality-improvement-intervention-to-improve-inpatient-pediatric-asthma-controller-accuracy
#5
Alexander H Hogan, Deepa Rastogi, Michael L Rinke
OBJECTIVES: Our objective was to investigate if a rigorous quality improvement (QI) intervention could increase accuracy of pediatric asthma controller medications on discharge from an inpatient hospitalization. METHODS: Our interprofessional QI team developed interventions such as improving documentation and creating standardized language to ensure patients were discharged on an appropriate asthma controller medication and improve assessment of asthma symptom control...
March 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29367458/a-pathophysiological-role-of-pde3-in-allergic-airway-inflammation
#6
Jan Beute, Melanie Lukkes, Ewout P Koekoek, Hedwika Nastiti, Keerthana Ganesh, Marjolein Jw de Bruijn, Steve Hockman, Menno van Nimwegen, Gert-Jan Braunstahl, Louis Boon, Bart N Lambrecht, Vince C Manganiello, Rudi W Hendriks, Alex KleinJan
Phosphodiesterase 3 (PDE3) and PDE4 regulate levels of cyclic AMP, which are critical in various cell types involved in allergic airway inflammation. Although PDE4 inhibition attenuates allergic airway inflammation, reported side effects preclude its application as an antiasthma drug in humans. Case reports showed that enoximone, which is a smooth muscle relaxant that inhibits PDE3, is beneficial and lifesaving in status asthmaticus and is well tolerated. However, clinical observations also showed antiinflammatory effects of PDE3 inhibition...
January 25, 2018: JCI Insight
https://www.readbyqxmd.com/read/29183453/the-age-related-characteristics-of-adults-with-asthma-who-visited-emergency-departments-in-korea-from-2007-to-2012
#7
Mi-Hee Lee, Hye-Jin Seo, Eun Ju Shin, Youn Kyoung Won, Yu Mi Jung, Seung-Hee Suh, Jin-Young Jeong, Young Shil Lim, You Young Kim, Eun Hee Chung
BACKGROUND: Understanding the patterns of emergency department (ED) visits of patients with asthma is important for disease control and prevention of exacerbations. OBJECTIVE: This study aimed to investigate the characteristics of adult patients who visited EDs because of their asthma. METHODS: Patients with asthma, ages ≥19 years old, who visited 117 EDs throughout Korea between January 2007 and December 2012 were identified in the National Emergency Department Information System (NEDIS) data base using the International Classification of Disease, 10th revision, codes J45 (asthma) and J46 (status asthmaticus)...
March 28, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29131536/non-invasive-ventilation-use-in-status-asthmaticus-16-years-of-experience-in-a-tertiary-intensive-care
#8
Kirsten Rl Bond, Carl Ae Horsley, Anthony B Williams
OBJECTIVE: To describe the use of non-invasive ventilation (NIV) in adults presenting with status asthmaticus to Middlemore Hospital Critical Care Complex (CCC, South Auckland, New Zealand) from 2000 to 2015. METHOD: Retrospective review of all adult asthma admissions to the Hospital CCC between 2000 and 2015. Demographic, physiological, treatment data and blood gas results were recorded. RESULTS: There were 265 asthma admissions to Middlemore Hospital CCC during the study period...
April 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29098494/toxicity-of-inhaled-agents-after-prolonged-administration
#9
Panumart Manatpon, W Andrew Kofke
Inhaled anesthetics have been utilized mostly for general anesthesia in the operating room and oftentimes for sedation and for treatment of refractory status epilepticus and status asthmaticus in the intensive care unit. These contexts in the ICU setting are related to potential for prolonged administration wherein potential organ toxicity is a concern. Over the last decade, several clinical and animal studies of neurotoxicity attributable to inhaled anesthetics have been emerging, particularly in extremes of age...
November 2, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28927779/extracorporeal-membrane-oxygenation-ecmo-and-ultraprotective-mechanical-ventilation-for-near-fatal-status-asthmaticus
#10
Y Corcia-Palomo, L Martín-Villén, S Escalona-Rodríguez, A Roldán Reina, A Adsuar-Gómez, R Martín-Bermúdez
No abstract text is available yet for this article.
September 16, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28867295/asthma-outcomes-and-management-during-pregnancy
#11
REVIEW
Catherine A Bonham, Karen C Patterson, Mary E Strek
Asthma during pregnancy poses a common, increasingly prevalent threat to the health of women and their children. The present article reviews recent insights gained from the epidemiology of asthma during pregnancy, demonstrating the many short- and long-term risks to mother and fetus incurred by poorly controlled maternal asthma. We further discuss emerging evidence that active management of asthma during pregnancy can positively influence and perhaps completely mitigate these poor outcomes. Recent high-quality trials examining best methods for asthma treatment are reviewed and synthesized to offer an evidence-based pathway for comprehensive treatment of asthma in the outpatient setting...
February 2018: Chest
https://www.readbyqxmd.com/read/28759291/years-of-life-lost-due-to-bronchial-asthma-in-poland-between-1999-2013
#12
Paulina Paciej, Elżbieta Dziankowska-Zaborszczyk, Beata Ciabiada, Marek Bryła, Irena Maniecka-Bryła
OBJECTIVE: The aim of this study was to analyze the years of life lost due to asthma in Poland between 1999-2013, with the use of the SEYLL measure (Standard Expected Years of Life Lost). METHODS: The study was based on a dataset of 5 606 516 records gathered from death certificates of Polish residents from 1999-2013. The data on the deaths due to bronchial asthma and status asthmaticus (J45 and J46 according to ICD-10) were used for the analysis. The SEYLL, SEYLLp (SEYLL per person) and SEYLLd (SEYLL per death) were implemented to assess lost life years...
July 31, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28754757/adjunctive-extracorporeal-carbon-dioxide-removal-in-refractory-status-asthmaticus
#13
Chuan Jiang, Jodi Galaydick, Harold Fernandez, Jonathan Caronia
Status asthmaticus (SA) is a life-threatening disorder. Severe respiratory failure may require extracorporeal membrane oxygenation (ECMO). Previous reports have demonstrated utility of ECMO in SA in various patients with varying success. A 25-year-old man was admitted with status asthmatics and severe hypercapnic respiratory failure. Despite tailored ventilator therapies, such as pressure control ventilation and maximal pharmacological therapy, including general anaesthesia, the patient’s condition deteriorated rapidly...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28612677/an-unusual-complication-with-the-administration-of-a-volatile-anesthetic-agent-for-status-asthmaticus-in-the-pediatric-intensive-care-unit-case-report-and-review-of-the-literature
#14
Brittany Shutes, W Joshua Frazier, Joseph D Tobias
In severe cases of status asthmaticus, when conventional therapies fail, volatile anesthetic agents remain a therapeutic option. When delivered outside of the operating room setting, specialized delivery techniques are needed to ensure the safe and effective use of volatile anesthetic agents. We present a 16-year-old adolescent with status asthmaticus who required the therapeutic administration of the volatile anesthetic agent, sevoflurane, in the pediatric intensive care unit (PICU). Although initially effective in reducing bronchospasm, progressive hypercarbia developed due to defective functioning of the carbon dioxide absorber of the anesthesia machine...
July 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28598946/dexmedetomidine-for-sedation-during-noninvasive-ventilation-in-pediatric-patients
#15
Rasika Venkatraman, James L Hungerford, Mark W Hall, Melissa Moore-Clingenpeel, Joseph D Tobias
OBJECTIVES: To describe the use of dexmedetomidine for sedation in a large cohort of nonintubated children with acute respiratory insufficiency receiving noninvasive ventilatory support. DESIGN: Single-center, retrospective, observational cohort study. SETTING: A large quaternary-care PICU. PATIENTS: The study cohort included 202 children receiving noninvasive ventilatory and a dexmedetomidine infusion within 48 hours of PICU admission over a 6-month period...
September 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28588119/high-flow-nasal-cannula-utilization-in-pediatric-critical-care
#16
Kristen D Coletti, Dayanand N Bagdure, Linda K Walker, Kenneth E Remy, Jason W Custer
BACKGROUND: High-flow nasal cannula (HFNC) is increasingly utilized in pediatrics, delivering humidified air and oxygen for respiratory conditions causing hypoxia and distress. In the neonatal ICU, it has been associated with better tolerance, lower complications, and lower cost. Few data exist regarding indications for use and the epidemiology of disease/pathology that warrants HFNC in the pediatric ICU. METHODS: This study is a retrospective cohort study of patients admitted to a tertiary children's hospital pediatric ICU and placed on HFNC from October 1, 2011 to October 31, 2013...
August 2017: Respiratory Care
https://www.readbyqxmd.com/read/28555168/a-case-of-sevoflurane-use-during-pregnancy-in-the-management-of-persistent-status-asthmaticus
#17
Jessica Parrott, Mitch Tener, Katie Dennis, Matthew Sharpe, Cecily Clark-Ganheart
BACKGROUND: Sevoflurane is rarely used for the treatment of status asthmaticus. We report a case of sevoflurane hepatotoxicity in pregnancy with presentation similar to HELLP syndrome. CASE: A G2P1001 at 23 weeks in status asthmaticus presented with pCO2 > 130 and pH < 7. She was nonresponsive to traditional therapy. Sevoflurane was added for a 24 hr period. Respiratory status improved. Extubation occurred on day 12. Workup for preeclampsia spectrum disorders occurred due to maternal hypertension...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28546381/adjunct-therapies-for-refractory-status-asthmaticus-in-children
#18
REVIEW
Kyle J Rehder
Asthma exacerbation is a common reason for children to present to the emergency department. If primary therapies fail to halt the progression of an asthma flare, status asthmaticus often leads to hospital, and potentially ICU, admission. Following the initial administration of inhaled β agonists and systemic corticosteroids, a wide array of adjunct medical therapies may be used to treat status asthmaticus. Unfortunately, the data supporting the use of these adjunct therapies are often unclear, conflicting, or absent...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28538609/critical-care-interventions-for-asthmatic-patients-admitted-from-the-emergency-department-to-the-pediatric-intensive-care-unit
#19
Kristen Michelle Cundiff, James M Gerard, Robert G Flood
OBJECTIVES: The aim of this study was to assess the frequency and predictors of critical interventions in asthmatic patients admitted to the pediatric intensive care unit (PICU) at a tertiary-care pediatric hospital. METHODS: We conducted a retrospective chart review of patients admitted from our emergency department (ED) to the PICU for treatment of status asthmaticus between January 1, 2008, and March 31, 2013. Patients with concomitant medical conditions and those who received a critical intervention, other than continuously aerosolized albuterol, in the ED before admission were excluded...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28534235/nasal-high-flow-in-management-of-children-with-status-asthmaticus-a-retrospective-observational-study
#20
Florent Baudin, Alexandra Buisson, Blandine Vanel, Bruno Massenavette, Robin Pouyau, Etienne Javouhey
BACKGROUND: Asthma is the most common obstructive airway disease in children and adults. Nasal high flow (NHF) is a recent device that is now used as a primary support for respiratory distress. Several studies have reported use of NHF as a respiratory support in status asthmaticus; however, there are no data to recommend such practice. We therefore conducted this preliminary study to evaluate NHF therapy for children with status asthmaticus admitted to our PICU in order to prepare a multicentre randomized controlled study...
December 2017: Annals of Intensive Care
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