Your browser doesn't support javascript.
loading
Severe acute asthma in a pediatric intensive care unit: six years' experience.
Stein, R; Canny, G J; Bohn, D J; Reisman, J J; Levison, H.
Afiliación
  • Stein R; Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatrics ; 83(6): 1023-8, 1989 Jun.
Article en En | MEDLINE | ID: mdl-2726328
The management of children with severe acute asthma who required admission to the intensive care (ICU) of this hospital during 1982 to 1988 was reviewed retrospectively. A total of 89 children were admitted to the ICU on 125 occasions. During the study period, 24% of the patients were admitted to the ICU on more than one occasion. Prior to admission to this hospital, patients had been symptomatic for a mean of 48 hours. Although all patients had received bronchodilators before admission to hospital, only 23% of patients had received oral corticosteroids. According to initial arterial blood gas values determined in the ICU, 77% of the patients had hypercapnia (PaCO2 greater than 45 mm Hg). The pharmacologic agents used in the ICU included nebulized beta 2-agonists (100% of admissions), theophylline (99%), steroids (94%), nebulized ipratropium bromide (10%), IV albuterol (38%), and IV isoproterenol (10%). Mechanical ventilation was necessary in 33% of admissions; the mean duration of ventilation was 32 hours. Ten patients had pneumothorax; in six cases, these were related to mechanical ventilation. Three of the patients who received mechanical ventilation died, representing a mortality of 7.5%. In each of these patients, sudden, severe asthma episodes had developed at home, resulting in respiratory arrest. They had evidence of hypoxic encephalopathy at the time of admission to the ICU and eventually were declared brain dead. It was concluded that delay in seeking medical care and underuse of oral corticosteroids at home may have contributed to the need for ICU admission.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Buscar en Google
Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Asma / Unidades de Cuidados Intensivos Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: America do norte Idioma: En Revista: Pediatrics Año: 1989 Tipo del documento: Article País de afiliación: Canadá
Buscar en Google
Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Asma / Unidades de Cuidados Intensivos Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: America do norte Idioma: En Revista: Pediatrics Año: 1989 Tipo del documento: Article País de afiliación: Canadá