title: Long-term outcome after pediatric intensive care unit asthma admissions.
abstract: BACKGROUND
  Patients with asthma admitted to the pediatric intensive care unit (PICU) are often found to have had previous severe asthma exacerbations.
  
  
  OBJECTIVE
  To prospectively evaluate the outcome of children after PICU admission.
  
  
  METHODS
  Patients, ages 218 years, admitted to the PICU at Assaf Harofeh Medical Center over a 10-year period were assessed at a mean of 10 years after their admission and compared with matched patients admitted to the pediatric ward. Each patient filled out a questionnaire on subsequent hospitalizations and current asthma treatment and control. Pulmonary function studies and allergy skin tests were performed.
  
  
  RESULTS
  Compared with patients admitted to the pediatric ward, those admitted to the PICU had more hospitalization and ICU admissions after their index admission (p = 0.022 and p = 0.021, respectively). Most patients in both groups (6070%) had uncontrolled asthma, and 47% of those (PICU) and 33% (ward) were not receiving controller therapy. Patients in the PICU group had more recent asthma exacerbations (p = 0.014), weekly wheezing (p = 0.017), and bronchodilator use (p = 0.007). Lung function tests were comparable between the two groups, but 3045% in each group had airflow obstruction. No significant differences were found between preschool and school-age children in any of the parameters.
  
  
  CONCLUSIONS
  Compared with patients admitted to the pediatric ward, those admitted to the PICU with asthma exacerbations, experienced more asthma-related hospitalizations and their asthma was less controlled even years later. The lack of regular follow-up and controller therapy in most patients after asthma hospitalization indicated that this increased morbidity might be prevented.
authors.affiliation: Pediatric Critical Care Unit, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abu-Kishk
authors.forename: Sharon
authors.initials: S
authors.lastname: Polakow-Farkash
authors.forename: Arnon
authors.initials: A
authors.lastname: Elizur
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D012129:Respiratory Function Tests; D012882:Skin Tests
chemical_list: D001993:Bronchodilator Agents