哮喘联盟

   摘要
   目的：本试验旨在了解三级医院儿科重症监护室（PICU）治疗的哮喘持续状态患儿的人口统计学、临床病程和转归。
   方法：对美国俄亥俄州国立儿童医院2000年至2007年间PICU治疗的哮喘持续状态的5岁以上患儿进行回顾性研究。数据来自于183名患儿。
   结果：入院时的年龄为11±3.8岁。平均PICU时间为1天（1～12天），平均住院时间为3天。通气组（n=17）患儿的PICU时间和住院时间均延长2天。接近半数的患儿（n=91; 50%）未采用每日哮喘控制治疗。病历记载有125名患儿对哮喘用药的依从性，其中43名（34%）具有较好的依从性。167名患儿有吸烟暴露记录，其中70名患儿（42%）存在吸烟暴露。接受压力定量气雾剂（MDI）吸入治疗的患儿中，仅39名（18%）患儿正在使用。105名有哮喘严重程度记录的患儿中，21名（20%）患儿诊断为轻度间歇性哮喘，29名（28%）诊断为轻度持续哮喘，26名（25%）诊断为中度持续哮喘，29名（28%）诊断为严重持续哮喘。与研究期内仅一次PICU住院的患儿（n=161）相比，多次PICU住院的患儿（n=22）具有更多的哮喘急诊就医和住院。未见死亡患者。
   结论：各种严重程度的哮喘患者均可出现需要PICU治疗的危及生命的哮喘发作，特别是那些对每日哮喘治疗依从性较差的患者。
 

（苏楠 审校）
J Asthma. 2013 Feb 5. [Epub ahead of print]

 

Demographics, Clinical Course, and Outcomes of Children with Status Asthmaticus Treated in a Pediatric Intensive Care Unit: 8-Year Review.
 
Sheikh S, Khan N, Ryan-Wenger NA, McCoy KS.

Source
Division of Pulmonary Medicine, Department of Pediatrics, Nationwide Children's Hospital , Columbus, Ohio , USA.

Abstract 
OBJECTIVE:This study was done to understand the demographics, clinical course, and outcomes of children with status asthmaticus treated in a tertiary care pediatric intensive care unit (PICU).
METHODS:The medical charts of all patients above 5 years of age admitted to the PICU at Nationwide Children's Hospital, Columbus, OH, USA, with status asthmaticus from 2000 to 2007 were reviewed retrospectively. Data from 222 encounters by 183 children were analyzed.
RESULTS:The mean age at admission in years was 11 ± 3.8. The median PICU stay was 1 day (range, 1-12 days) and median hospital stay was 3 days. The ventilated group (n = 17) stayed a median of 2 days longer in the PICU and hospital. Nearly half of the children (n = 91; 50%) did not receive daily controller asthma medications.Adherence to asthma medications was reported in 125 patient charts of whom 43 (34%) were compliant. Exposure to smoking was reported in 167 of whom 70 (42%) were exposed. Among patients receiving metered dose inhaler (MDI), only 39 (18%) were using it with a spacer. Among 105 patient charts asthma severity data were available, of them 21 (20%) were labeled as mild intermittent, 29 (28%) were mild persistent, 26 (25%) were moderate persistent, and 29 (28%) were severe persistent. Compared to children with only one PICU admission during the study period (n = 161), children who had multiple PICU admissions (n = 22) experienced more prior emergency department visits and hospitalizations for asthma symptoms. There were no fatalities.
CONCLUSION:Asthmatics with any disease severity are at risk for life-threatening asthma exacerbations requiring PICU stay, especially those who are not adherent with their daily medications.

J Asthma. 2013 Feb 5. [Epub ahead of print]