Clinical course and outcome of children with status asthmaticus treated in a pediatric intensive care unit: a 15-year review.
OBJECTIVE
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.
Chiang
Bor Luen
BL
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. gicmbor@ntu.edu.tw
Hsieh
Chin Tung
CT
Wang
Li Chieh
LC
Lee
Jyh Hong
JH
Yu
Hsin Hui
HH
Lin
Yu Tsan
YT
Yang
Yao Hsu
YH
D000293:Adolescent; D000367:Age Factors; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D012008:Recurrence; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012621:Seasons; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013224:Status Asthmaticus / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
D018927:Anti-Asthmatic Agents