Pulmonary specialist involvement in critical asthma in the pediatric intensive care unit: A retrospective review

Janaki Paskaradevan*, Mackenzie Zier, Brian Rissmiller, Julie P. Katkin, Jorge A. Coss-Bu, M. Carolina Gazzaneo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Asthma is one of the most common chronic diseases of childhood. There is a scarcity of published literature on critical asthma, considered acute asthma requiring pediatric intensive care unit (PICU) admission. The goal of this study was to describe the clinical care of children with critical asthma admitted to a single center PICU and to determine whether pulmonary medicine consultation during admission impacted outcomes. Methods: Retrospective chart review of known asthma patients aged 4–18 years admitted to a quaternary PICU between 01/2013 and 07/2019 for management of critical asthma. Results: A total of 179 patients were enrolled with median age of 8 years. Median hospital length of stay (LOS) was 3.2 days and PICU LOS was 1.5 days. A total of 80 (44.7%) patients had a pulmonary medicine consultation. In the pulmonary medicine consultation group versus the no-pulmonary medicine consultation group, there was a significant difference in hospital LOS (4.16 vs. 2.86 days, p value <.0001) and PICU LOS (2.00 vs. 1.00, p value <.0001), escalation of controller medication (66% vs. 21%, p value <.0001), scheduled outpatient pulmonology follow-up (87.5% vs. 45.4%, p value <.0001), and receiving ≥3 courses of systemic steroids in the 12 months after discharge (32.2% vs. 14.7%). There was no difference in attendance of scheduled follow up appointments or in having ≥3 emergency room visits or admissions in the 12 months after discharge. Conclusion: Pulmonary medicine consultation during hospital admission may impact management of critical asthma by increasing escalation of controller medication and scheduled outpatient follow up.

Original languageEnglish (US)
Pages (from-to)395-402
Number of pages8
JournalPediatric Pulmonology
Volume57
Issue number2
DOIs
StatePublished - Feb 2022
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

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