TY - JOUR
T1 - Pulmonary specialist involvement in critical asthma in the pediatric intensive care unit
T2 - A retrospective review
AU - Paskaradevan, Janaki
AU - Zier, Mackenzie
AU - Rissmiller, Brian
AU - Katkin, Julie P.
AU - Coss-Bu, Jorge A.
AU - Gazzaneo, M. Carolina
N1 - Publisher Copyright:
© 2021 Wiley Periodicals LLC
PY - 2022/2
Y1 - 2022/2
N2 - 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.
AB - 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.
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U2 - 10.1002/ppul.25780
DO - 10.1002/ppul.25780
M3 - Article
C2 - 34861100
AN - SCOPUS:85120798533
SN - 8755-6863
VL - 57
SP - 395
EP - 402
JO - Pediatric Pulmonology
JF - Pediatric Pulmonology
IS - 2
ER -