OBJECTIVE: To characterize the clinical course, therapies, and outcomes of children with fatal and near-fatal asthma admitted to pediatric intensive care units (PICUs). STUDY DESIGN: This was a retrospective chart abstraction across the 8 tertiary care PICUs of the Collaborative Pediatric Critical Care Research Network (CPCCRN). Inclusion criteria were children (aged 1-18 years) admitted between 2005 and 2009 (inclusive) for asthma who received ventilation (near-fatal) or died (fatal). Data collected included medications, ventilator strategies, concomitant therapies, demographic information, and risk variables. RESULTS: Of the 261 eligible children, 33 (13%) had no previous history of asthma, 218 (84%) survived with no known complications, and 32 (12%) had complications. Eleven (4%) died, 10 of whom had experienced cardiac arrest before admission. Patients intubated outside the PICU had a shorter duration of ventilation (median, 25 hours vs 84 hours; P < .001). African-Americans were disproportionately represented among the intubated children and had a shorter duration of intubation. Barotrauma occurred in 15 children (6%) before admission. Pharmacologic therapy was highly variable, with similar outcomes. CONCLUSION: Of the children ventilated in the CPCCRN PICUs, 96% survived to hospital discharge. Most of the children who died experienced cardiac arrest before admission. Intubation outside the PICU was correlated with shorter duration of ventilation. Complications of barotrauma and neuromyopathy were uncommon. Practice patterns varied widely among the CPCCRN sites.
OBJECTIVE: To characterize the clinical course, therapies, and outcomes of children with fatal and near-fatal asthma admitted to pediatric intensive care units (PICUs). STUDY DESIGN: This was a retrospective chart abstraction across the 8 tertiary care PICUs of the Collaborative Pediatric Critical Care Research Network (CPCCRN). Inclusion criteria were children (aged 1-18 years) admitted between 2005 and 2009 (inclusive) for asthma who received ventilation (near-fatal) or died (fatal). Data collected included medications, ventilator strategies, concomitant therapies, demographic information, and risk variables. RESULTS: Of the 261 eligible children, 33 (13%) had no previous history of asthma, 218 (84%) survived with no known complications, and 32 (12%) had complications. Eleven (4%) died, 10 of whom had experienced cardiac arrest before admission. Patients intubated outside the PICU had a shorter duration of ventilation (median, 25 hours vs 84 hours; P < .001). African-Americans were disproportionately represented among the intubated children and had a shorter duration of intubation. Barotrauma occurred in 15 children (6%) before admission. Pharmacologic therapy was highly variable, with similar outcomes. CONCLUSION: Of the children ventilated in the CPCCRN PICUs, 96% survived to hospital discharge. Most of the children who died experienced cardiac arrest before admission. Intubation outside the PICU was correlated with shorter duration of ventilation. Complications of barotrauma and neuromyopathy were uncommon. Practice patterns varied widely among the CPCCRN sites.
Authors: Christopher L Carroll; Sharon R Smith; Melanie S Collins; Anita Bhandari; Craig M Schramm; Aaron R Zucker Journal: Pediatr Crit Care Med Date: 2007-03 Impact factor: 3.624
Authors: Allan Doctor; Jerry Zimmerman; Michael Agus; Surender Rajasekaran; Juliane Bubeck Wardenburg; James Fortenberry; Anne Zajicek; Emma Mairson; Katri Typpo Journal: Pediatr Crit Care Med Date: 2017-03 Impact factor: 3.624
Authors: Stanley J Szefler; James F Chmiel; Anne M Fitzpatrick; George Giacoia; Thomas P Green; Daniel J Jackson; Heber C Nielsen; Wanda Phipatanakul; Hengameh H Raissy Journal: J Allergy Clin Immunol Date: 2013-11-28 Impact factor: 10.793
Authors: Jarred R Mondoñedo; John S McNeil; Samir D Amin; Jacob Herrmann; Brett A Simon; David W Kaczka Journal: Drug Discov Today Dis Models Date: 2014-04-29
Authors: Steven L Shein; Richard H Speicher; José Oliva Proença Filho; Benjamin Gaston; Alexandre T Rotta Journal: Rev Bras Ter Intensiva Date: 2016-06