RT Journal Article
SR Electronic
T1 Risk factors for intensive care admission in children with severe acute asthma in the Netherlands: a prospective multicentre study
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00126-2020
DO 10.1183/23120541.00126-2020
VO 6
IS 3
A1 Shelley A. Boeschoten
A1 Annemie L. Boehmer
A1 Peter J. Merkus
A1 Joost van Rosmalen
A1 Johan C. de Jongste
A1 Pieter L.A. Fraaij
A1 Richard Molenkamp
A1 Sabien G. Heisterkamp
A1 Job B. van Woensel
A1 Berber Kapitein
A1 Eric G. Haarman
A1 Roelie M. Wösten-van Asperen
A1 Martin C. Kneyber
A1 Joris Lemson
A1 Stan Hartman
A1 Dick A. van Waardenburg
A1 Heleen E. Bunker-Wiersma
A1 Carole N. Brouwer
A1 Bart E. van Ewijk
A1 Anneke M. Landstra
A1 Mariel Verwaal
A1 Anja A. Vaessen-Verberne
A1 Sanne Hammer
A1 Corinne M. Buysse
A1 Matthijs de Hoog
YR 2020
UL http://openres.ersjournals.com/content/6/3/00126-2020.abstract
AB Rationale Severe acute asthma (SAA) can be fatal, but is often preventable. We previously observed in a retrospective cohort study, a three-fold increase in SAA paediatric intensive care (PICU) admissions between 2003 and 2013 in the Netherlands, with a significant increase during those years of numbers of children without treatment of inhaled corticosteroids (ICS).Objectives To determine whether steroid-naïve children are at higher risk of PICU admission among those hospitalised for SAA. Furthermore, we included the secondary risk factors tobacco smoke exposure, allergic sensitisation, previous admissions and viral infections.Methods A prospective, nationwide multicentre study of children with SAA (2–18 years) admitted to all Dutch PICUs and four general wards between 2016 and 2018. Potential risk factors for PICU admission were assessed using logistic regression analyses.Measurements and main results 110 PICU and 111 general ward patients were included. The proportion of steroid-naïve children did not differ significantly between PICU and ward patients. PICU children were significantly older and more exposed to tobacco smoke, with symptoms >1 week prior to admission. Viral susceptibility was not a significant risk factor for PICU admission.Conclusions Children with SAA admitted to a PICU were comparable to those admitted to a general ward with respect to ICS treatment prior to admission. Preventable risk factors for PICU admission were >7 days of symptoms without adjustment of therapy and exposure to tobacco smoke. Physicians who treat children with asthma must be aware of these risk factors.Preventable risk factors for PICU admission among those with severe acute asthma are >7 days of symptoms without adjustment of therapy and environmental exposure to tobacco smoke, underlining the importance of smoking cessation of caregivers https://bit.ly/3ezPzxT