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asthma managment in picu

Michelle Bosley Henderson, Jeff E Schunk, Jeffrey L Henderson, Gitte Y Larsen, Jacob Wilkes, Susan L Bratton
OBJECTIVES: To describe asthma management, investigate practice variation, and describe asthma-associated charges and resource use during asthma management in the PICU. METHODS: Children ages 2 to 18 years treated for status asthmaticus in the PICU from 2008 to 2011 are included in this study. This is a retrospective, single-center, cohort study. Data were collected by using the Intermountain Healthcare Enterprise Data Warehouse. RESULTS: There were 262 patients included and grouped by maximal respiratory support intervention...
May 24, 2018: Hospital Pediatrics
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
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
Georgina Martin, Rachel Li, Victoria E Cook, Matthew Carwana, Peter Tilley, Laura Sauve, Patrick Tang, Akshat Kapur, Connie L Yang
Background. In the fall of 2014, a North American outbreak of enterovirus D68 resulted in a significant number of pediatric hospital admissions for respiratory illness throughout North America. This study characterized the clinical presentation and risk factors for a severe clinical course in children admitted to British Columbia Children's Hospital during the 2014 outbreak. Methods. Retrospective chart review of patients with confirmed EV-D68 infection admitted to BCCH with respiratory symptoms in the fall of 2014...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Ayman A Al-Eyadhy, Mohamad-Hani Temsah, Ali A N Alhaboob, Abdulmalik K Aldubayan, Nasser A Almousa, Abdulrahman M Alsharidah, Mohammed I Alangari, Abdulrahman M Alshaya
OBJECTIVES: To describe the change in the management, and outcome of children with acute severe asthma (ASA) admitted to Pediatric Intensive Care Unit (PICU) at tertiary institute, as compared to previously published report in 2003. METHODS: This is a retrospective observational study. All consecutive pediatric ASA patients who were admitted to PICU during the study period were included. The data were extracted from PICU database and medical records. The Cohort in this study (2013 Cohort) was compared with the Cohort of ASA, which was published in 2003 from the same institution (2003 Cohort)...
October 2015: Annals of Thoracic Medicine
Jennifer E Schuster, Jenna O Miller, Rangaraj Selvarangan, Gina Weddle, Marita T Thompson, Ferdaus Hassan, Shannon L Rogers, M Steven Oberste, W Allan Nix, Mary Anne Jackson
BACKGROUND: Enterovirus 68 (EV-D68) causes acute respiratory tract illness in epidemic cycles, most recently in Fall 2014, but clinical characteristics of severe disease are not well reported. OBJECTIVES: Children with EV-D68 severe respiratory disease requiring pediatric intensive care unit (PICU) management were compared with children with severe respiratory disease from other enteroviruses/rhinoviruses. STUDY DESIGN: A retrospective review was performed of all children admitted to Children's Mercy Hospital PICU from August 1-September 15, 2014 with positive PCR testing for enterovirus/rhinovirus...
September 2015: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
J Carlos Maggi, Eliezer Nussbaum, Christopher Babbitt, Flavio E Maggi, Inderpal Randhawa
BACKGROUND: Status asthmaticus respiratory failure is associated with thickened mucus secretions necessitating aggressive pulmonary clearance. The role of bronchoscopy in pediatric mechanically ventilated asthmatic patients has not been published. METHODS: A chart review was performed on all pediatric intensive care unit (PICU) asthmatics with respiratory failure over 13 years. Forty-four patients were identified. Patients were managed per standardized guidelines for status asthmaticus with mechanical ventilation...
December 2012: Pediatric Pulmonology
Mary E Hartman, Walter T Linde-Zwirble, Derek C Angus, R Scott Watson
OBJECTIVE: Status asthmaticus accounts for a large portion of the morbidity and mortality associated with asthma, but we know little about its epidemiology. We describe here the hospitalization characteristics of children with status asthmaticus, how they changed over time, and how they differed between hospitals with and without PICUs. PATIENTS AND METHODS: We used administrative data from New Jersey that included all hospitalizations in the state from 1992, 1995, and 1999-2006...
October 2010: Pediatrics
Mariel Silva, Luis Muñoz, Tania Diaz, Weldon Mauney, Vylma Velázquez
Asthma morbidity and mortality have increased in the past two decades; Puerto Rican children have the highest prevalence of asthma in the United States. An asthma admission to PICU is a marker of asthma severity. This study describes the profile of the pediatric population admitted with status asthmaticus during a three year period to PICU at Hospital Episcopal San Lucas. An ambispective cohort chart review of 46 cases was performed; there was a mean average age of 6.2 years, male predominance (70%) and a strong family and personal history of asthma and allergies...
April 2009: Boletín de la Asociación Médica de Puerto Rico
Nicola M Vogel, Hary T Katz, Rocio Lopez, David M Lang
BACKGROUND: Risk factors for potentially fatal childhood asthma are incompletely understood. OBJECTIVE: To determine whether self-reported food allergy is significantly associated with potentially fatal childhood asthma. STUDY DESIGN: Medical records from 72 patients admitted to a pediatric intensive care unit (PICU) for asthmatic exacerbation were reviewed and compared in a case-control design with 2 randomly selected groups of 108 patients admitted to a regular nursing floor for asthma and 108 ambulatory patients with asthma...
December 2008: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Amanda Lynn Bogie, Deborah Towne, Peter M Luckett, Thomas J Abramo, Robert A Wiebe
OBJECTIVE: To determine if the addition of intravenous terbutaline provides any clinical benefit to children with acute severe asthma already on continuous high-dose nebulized albuterol. METHODS: We conducted a prospective, randomized, double blind, placebo-controlled trial on pediatric patients with acute severe asthma presenting to a large inner city tertiary children's emergency department. Consecutive patients between 2 and 17 years of age who failed acute asthma management and needed intensive care unit admission underwent informed consent and were enrolled into the study...
June 2007: Pediatric Emergency Care
Ruben D Restrepo, Robert Pettignano, Patrick DeMeuse
Asthma is the most common chronic disease of childhood. Despite a better understanding of the disease process and its management, status asthmaticus continues to be a life-threatening event. The use of volatile inhaled anesthetics is infrequently reported as adjunctive therapy to conventional treatment of this condition. We report the use of halothane in a mechanically ventilated pediatric patient with life-threatening status asthmaticus who was admitted to the pediatric intensive care unit (PICU) after failing to respond to standard medical therapy and noninvasive positive pressure ventilation...
October 2005: Journal of Asthma: Official Journal of the Association for the Care of Asthma
S Mintegi Raso, J Benito Fernández, S García González, A Corrales Fernández, María J Bartolomé Albistegui, N Trebolazabala Quirante
OBJECTIVE: To describe patient demand and management in a hospital pediatric emergency setting. PATIENTS AND METHOD: We analyzed the number of episodes registered in our pediatric emergency unit between 1995 and 2002 and performed a retrospective, random survey of 540 episodes in children aged less than 14 years admitted between 2001-10-1 and 2002-09-30. Epidemiological details, physical findings, complementary tests, the treatment administered, admissions, and unscheduled return visits were analyzed...
August 2004: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
J C Santana, S S Barreto, P R Carvalho
OBJECTIVE: To study the epidemiologic and clinical factors related to severe acute asthma in patients hospitalized in pediatric intensive care unit (PICU). STUDY PROFILE: Prospective, epidemiologic. All admissions were observed. PATIENTS AND METHODS: All children with severe asthma admitted to PICU-HSL-PUCRS between January, 1994, and December, 1994. Their parents were asked to answer a questionnaire about clinical history and precipitating factors of bronchospasm...
September 1997: Jornal de Pediatria
Krishan Chugh
Acute asthmatic exacerbation is one of the commonest emergencies seen in the pediatric age group. Viral infections are the most important triggers which set up the inflammatory reaction in the bronchial mucosa. GINA 2002 guidelines for assessing the severity and management are very useful for day to day practice. There is evidence to support the view that metered dose inhaler alongwith spaceor with or without mask is as effective as the standard doses of beta-2 agonists given by nebulizer. Ipratrpium bromide adds to the benefits of short acting beta-2 agonists...
March 2003: Indian Journal of Pediatrics
Faisal M Abu-Ekteish, Jihad N Zahraa, Khalid F Al-Mobaireek, Ali A Nasir, Abdulrahman S Al-Frayh
OBJECTIVE: The hospitalization and mortality rates incurred from acute childhood asthma continue to rise in the past decade. The purpose of this study is to examine the outcome, morbidity and the management of children admitted with acute asthma to our pediatric intensive care unit (PICU) and compare it with those described in the literature. METHODS: Medical records of all children admitted with acute severe asthma to PICU at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia over an 8-year period (1994-2001) were reviewed...
April 2003: Saudi Medical Journal
Gideon Eshel, Ravit Raviv, Ron Ben-Abraham, Joseph Barr, Mati Berkovitch, Ori Efrati, Amir Vardi, Zohar Barzilay, Gideon Paret
Childhood asthma morbidity and mortality are increasing despite improvements in asthma therapy. The changes over the past decade in the guidelines for treatment of children with severe asthma have led to a reduction in admissions and readmissions to the pediatric intensive care unit (PICU). The Israeli medical infrastructure is exemplary in its capability of extending appropriate medical services to its entire population. Our objective was to look at the background of preventive maintenance treatment and treatment during an acute episode in children admitted to PICUs with severe asthma, and to identify areas that could be targeted for change...
February 2002: Pediatric Pulmonology
R S Ream, L L Loftis, G M Albers, B A Becker, R E Lynch, R B Mink
STUDY OBJECTIVE: To determine whether adding IV theophylline to an aggressive regimen of inhaled and IV beta-agonists, inhaled ipratropium, and IV methylprednisolone would enhance the recovery of children with severe status asthmaticus admitted to the pediatric ICU (PICU). DESIGN: A prospective, randomized, controlled trial. Asthma scoring was performed by investigators not involved in treatment decisions and blinded to group assignment. SETTING: The PICU of an urban, university-affiliated, tertiary-care children's hospital...
May 2001: Chest
P M Jeena, A G Wesley, H M Coovadia
OBJECTIVE: To describe admission and outcome patterns of diseases managed at a paediatric intensive care unit (PICU) in a developing country between 1971 and 1995, in order to provide data which will assist in improving the management of diseases and the rational allocation of health resources. METHOD: This study is based on data collated from annual audits conducted by the head of the PICU, King Edward VIII Hospital, Durban, South Africa. This unit serves a childhood population of about 3-4 million aged from 0-12 years...
January 1999: Intensive Care Medicine
J Irazuzta, J Zhang, S Pandit
BACKGROUND: We investigated whether a recently restructured pediatric intensive care unit (PICU) had a decrease in the cost of patient care over the years. METHODS: We retrospectively studied 89 previously healthy patients admitted to the PICU of a community-based, university-affiliated teaching hospital over a 4-year period (1991 to 1994) for treatment of lower airway disease. Data collected were patient age, severity of illness, length of stay in both PICU and hospital, prorated hospital bill, year of admission, and patient-specific PICU-originated costs (POC)...
July 1998: Southern Medical Journal
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