1,963 results match your criteria Status Asthmaticus

Efficacy and Safety of Prolonged Magnesium Sulfate Infusions in Children With Refractory Status Asthmaticus.

Front Pediatr 2022 9;10:860921. Epub 2022 Jun 9.

Department of Pediatrics, Division of Critical Care Medicine, University of Oklahoma College of Medicine, Oklahoma City, OK, United States.

Objectives: There is a paucity of data on the use of intravenous magnesium sulfate infusion in children with refractory status asthmaticus. The purpose of this study was to evaluate the efficacy and safety of prolonged magnesium sulfate infusion as an advanced therapy.

Methods: This is a single center retrospective study of children admitted to our pediatric intensive care unit (PICU) with status asthmaticus requiring continuous albuterol. Read More

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Intensive Care Unit Acquired Weakness Associated With Acute Severe Asthma.

Clin Med Insights Case Rep 2022 20;15:11795476221106759. Epub 2022 Jun 20.

Division of Pulmonary and Critical Care Medicine, Gestión Salud IPS, Cartagena, Colombia.

Context: Neuromuscular complications in the intensive care unit (ICU) are frequent, multifactorial, and clinically difficult to recognize during their acute phase. The physical examination is the starting point for identification.

Case Report: We present a patient with a history of poorly controlled asthma who was admitted to the ICU with status asthmaticus. Read More

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Successful Utilization of Life-saving Extra-Corporeal CO2 Removal in Catastrophic Status Asthmaticus: A Case Report.

J Community Hosp Intern Med Perspect 2022 2;12(3):61-65. Epub 2022 May 2.

St. George's University School of Medicine, Grenada.

Acute asthma exacerbations can be severe and life-threatening. In some cases, standard interventions and management do not result in reversal of bronchoconstriction. It is crucial to detect patients with impending respiratory failure and escalate management to invasive mechanical ventilatory support and, in refractory cases, interventions like extracorporeal membrane oxygenation (ECMO). Read More

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Oral enoximone allows the reduction and discontinuation of inhaled steroids and beta2 agonists in asthmatic children.

Int J Pediatr Adolesc Med 2022 Jun 19;9(2):147-151. Epub 2021 Feb 19.

Department of Pulmonary Medicine, Erasmus MC, 's-Gravendijkwal 230, 3015, CE, Rotterdam, the Netherlands.

In the last two decades, improvement on asthma treatment has been merely marginal for both adults and children; inhaled corticosteroids (ICS) combined with β-2-mimetics remain the main therapy [3,4]. "New" therapies are just variations on ICS or, for children, on various other drugs that were allowed for adult asthma patients (clinicaltrials.gov). Read More

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Antibiotic use among admitted pediatric patients in the United States with status asthmaticus before and during the COVID-19 pandemic.

J Asthma 2022 Jun 6:1-8. Epub 2022 Jun 6.

Department of Pediatric Infectious Disease, Stony Brook University Children's Hospital, Stony Brook, NY, USA.

Objective: Hospital admission trends of children with status asthmaticus diminished during the Coronavirus-19 (COVID-19) pandemic of 2020, possibly secondary to several factors such as school closures and use of face masks. What effect this had on antibiotic prescribing practices has yet to be described. The objective of our study was to evaluate the use of antibiotics in hospitalized children with a diagnosis of status asthmaticus before and during the COVID pandemic. Read More

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A comparison of country-level data from the VISIONARY study examining treatment outcomes with preservative-free tafluprost/timolol fixed-dose combination therapy.

Curr Med Res Opin 2022 Jun 9:1-13. Epub 2022 Jun 9.

Glaucoma Unit, IRCSS-Fondazione Bietti, Rome, Italy.

Objective: Analysis and comparison of country-level data from the VISIONARY study, examining treatment outcomes with the topical fixed-dose combination of preservative-free tafluprost (0.0015%) and timolol (0.5%) (PF tafluprost/timolol FC) in adults with open-angle glaucoma (OAG) and ocular hypertension (OHT) who were insufficiently treated with or unable to tolerate either beta-blocker or prostaglandin analogue (PGA) topical monotherapy. Read More

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Rapid Viscoelastic Characterization of Airway Mucus using a Benchtop Rheometer.

J Vis Exp 2022 04 21(182). Epub 2022 Apr 21.

Marsico Lung Institute / CF Center, The University of North Carolina at Chapel Hill; Department of Pediatric, Pediatric Pulmonology Division, The University of North Carolina at Chapel Hill;

In muco-obstructive lung diseases (e.g., asthma, chronic obstructive pulmonary disease, cystic fibrosis) and other respiratory conditions (e. Read More

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Heliox Prescribing Trends for Pediatric Critical Asthma.

Respir Care 2022 05;67(5):510-519

Department of Anesthesia and Critical Care Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.

Background: Children with asthma exacerbations requiring pediatric ICU (PICU) admission, known as critical asthma (CA), are prescribed a variety of therapeutic interventions including heliox. Delivered invasively and noninvasively, heliox is employed to enhance deposition of aerosolized medications, improve obstructive pulmonary pathophysiology, and avoid complications associated with invasive mechanical ventilation. We used the Virtual Pediatric Systems database to update estimates of heliox prescription and explore for relationships between heliox and mechanical ventilation frequency and duration. Read More

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Current Practice and Rationale of Prescribing Dexamethasone for Pediatric Patients Hospitalized for Asthma.

WMJ 2022 Apr;121(1):30-35

Medical College of Wisconsin, Children's Wisconsin, Milwaukee, Wisconsin.

Objective: Dexamethasone use for pediatric asthma exacerbations in the emergency department is supported in literature as a beneficial alternative to prednisone; however, there is limited data in the hospital setting. This study assesses factors that influence pediatric hospital providers' steroid choice for patients hospitalized for status asthmaticus.

Methods: A survey was developed to assess factors influencing steroid prescribing practices. Read More

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Lung Ultrasound Artifact Findings in Pediatric Patients Admitted to the Intensive Care Unit for Acute Respiratory Failure.

J Ultrasound 2022 Apr 10. Epub 2022 Apr 10.

Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.

Purpose: To describe point-of-care lung ultrasound (POC-LUS) artifact findings in children admitted to the pediatric intensive care unit (PICU) for acute respiratory failure (ARF).

Methods: This is a secondary analysis of a prospective observational study completed in a 21-bed PICU. Children > 37 weeks gestational age and ≤ 18 years were enrolled from December 2018 to February 2020. Read More

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Continuous Magnesium Sulfate Infusions for Status Asthmaticus in Children: A Systematic Review.

Front Pediatr 2022 22;10:853574. Epub 2022 Mar 22.

Division of Critical Care Medicine, Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, OK, United States.

Objectives: Magnesium sulfate is a second-tier therapy for asthma exacerbations in children; guidelines recommend a single-dose to improve pulmonary function and decrease the odds of admission to the in-patient setting. However, many clinicians utilize prolonged magnesium sulfate infusions for children with refractory asthma. The purpose of this review is to describe the efficacy and safety of magnesium sulfate infusions administered over ≥ 1 h in children with status asthmaticus. Read More

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Rescue therapy for refractory status asthmaticus with updosed omalizumab adjusted for IgE level, body weight and effect.

Respir Med Case Rep 2022 22;36:101614. Epub 2022 Feb 22.

Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Am Klinikum 1, Germany.

Status asthmaticus is a life-threatening condition with a high mortality rate of up to 10.3% [1].Milger et al. Read More

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February 2022

Dexamethasone for Pediatric Critical Asthma: A Multicenter Descriptive Study.

J Intensive Care Med 2022 Mar 3:8850666221082540. Epub 2022 Mar 3.

Institute for Clinical and Translational Research, 7582Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.

Background: Systemic corticosteroids are vital to critical asthma management. While intravenous methylprednisolone is routinely used in the pediatric intensive care unit (PICU) setting, recent data supports dexamethasone as an alternative. Using the Pediatric Health Information System (PHIS) registry, we assessed trends and variation in corticosteroid prescribing among children hospitalized for critical asthma. Read More

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Endotracheal Tube Size Is Associated With Mortality in Status Asthmaticus: A Confirmation of the Suspicion?

Tim W Gilmore

Respir Care 2022 03;67(3):373-374

Louisiana State University Health ShreveportSchool of Allied health ProfessionsShreveport, Louisiana

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Endotracheal Tube Size Is Associated With Mortality in Patients With Status Asthmaticus.

Respir Care 2022 03;67(3):283-290

Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, Virginia.

Background: There is limited evidence on the clinical importance of the endotracheal tube (ETT) size selection in patients with status asthmaticus who require invasive mechanical ventilation. We set out to explore the clinical outcomes of different ETT internal diameter sizes in subjects mechanically ventilated with status asthmaticus.

Methods: This was a retrospective study of intubated and non-intubated adults admitted for status asthmaticus between 2014-2021. Read More

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A pediatric hospital-wide asthma severity score: Reliability and effectiveness.

Pediatr Pulmonol 2022 05 28;57(5):1223-1228. Epub 2022 Mar 28.

Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.

Background: Asthma is a leading cause of pediatric hospitalization in the United States. Children hospitalized with asthma are often managed in different care settings during hospitalization, posing challenges to accurate communication among care providers about illness severity. Our objective was to study the feasibility, reliability, and safety of a new pediatric hospital-wide asthma severity score (HASS) across different care units within a single tertiary-care pediatric center. Read More

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Management of Acute Asthma in Children.

Indian J Pediatr 2022 Apr 11;89(4):366-372. Epub 2022 Feb 11.

Division of Pediatric Pulmonology and Sleep, Department of Pediatrics, KTPNUCMI, National University Hospital, Singapore, 119228, Singapore.

Asthma is the most common disease of childhood globally and acute asthma is the most significant risk factor for asthma-related death and chronic complications. This article will aim to synthesize the most up-to-date research and translate it into a more practical guide to managing acute asthma on a more daily basis. The use of clinical severity score is reviewed alongside the use of history and clinical findings in making objective assessments of patients presenting with acute asthma. Read More

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COVID-19 Pneumonia and Status Asthmaticus With Respiratory Failure in a Pediatric Patient: A Simulation for Emergency Medicine Providers.

MedEdPORTAL 2022 21;18:11214. Epub 2022 Jan 21.

Assistant Professor, Division of Pediatric Emergency Medicine, Departments of Emergency Medicine and Pediatrics, Warren Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital; Director of Pediatric Simulation, Lifespan Medical Simulation Center.

Introduction: During COVID-19 surges, medical trainees may perform patient care outside typical clinical responsibilities. While respiratory failure in pediatric patients secondary to COVID-19 is rare, it is critical that providers can effectively care for these children while protecting the health care team. Simulation is an important tool for giving learners a safe environment in which to learn and practice these new skills. Read More

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February 2022

Patients Diagnosed with Multisystem Inflammatory Syndrome in Children Have Persistent Neurologic, Sleep, and Psychiatric Symptoms After Hospitalization.

J Child Neurol 2022 04 24;37(5):426-433. Epub 2022 Jan 24.

Division of Pediatric Neurology, Department of Pediatrics, Cohen Children's Medical Center, NY, USA.

Acute neurological complications from COVID-19 have been reported in both pediatric and adult populations. Chronic symptoms after recovery have been reported in adults and can include neuropsychiatric and sleep symptoms. Persistent symptoms in children with the multisystem inflammatory syndrome in children (MIS-C) have not been studied. Read More

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Reducing Avoidable Transfer Delays in the Pediatric Intensive Care Unit for Status Asthmaticus Patients.

Pediatr Qual Saf 2022 Jan-Feb;7(1):e527. Epub 2022 Jan 21.

Department of Pediatrics, Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus, Ohio.

Introduction: Status asthmaticus (acute severe asthma) is one of the most common reasons for Pediatric Intensive Care Unit (PICU) admission. Accordingly, ensuring optimal throughput for patients admitted with status asthmaticus is essential for optimizing PICU capacity. Few studies specifically address effective methods to reduce delays related to PICU discharge. Read More

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January 2022

Hypokalemia Measurement and Management in Patients With Status Asthmaticus on Continuous Albuterol.

Hosp Pediatr 2022 02;12(2):198-204

Divisions of Critical Care Medicine.

Objective: Status asthmaticus is commonly treated in pediatric patients by using continuous albuterol, which can cause hypokalemia. The primary aim of this study was to determine if serial potassium monitoring is necessary by examining treatment frequency of hypokalemia.

Methods: This retrospective analysis was performed in 185 pediatric patients admitted with status asthmaticus requiring continuous albuterol between 2017 and 2019. Read More

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February 2022

Cryptococcus neoformans in Association with Dermatophagoides pteronyssinus has Pro- (IL-6/STAT3 Overproduction) and Anti-inflammatory (CCL2/ERK1/2 Downregulation) Effects on Human Bronchial Epithelial Cells.

Inflammation 2022 Jun 11;45(3):1269-1280. Epub 2022 Jan 11.

Department of Clinical Medicine, Laboratory of Experimental Immunopharmacology, Institute of Health Sciences, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil.

Cryptococcosis (caused, for example, by Cryptococcus neoformans) and allergic asthma (caused, for example, by Dermatophagoides pteronyssinus) target the respiratory tract (the lung and bronchial epithelium). C. neoformans and D. Read More

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Myasthenia Gravis Masquerading as Status Asthmaticus.

Case Rep Pediatr 2021 28;2021:6959701. Epub 2021 Dec 28.

Affiliated with Albany Medical Center, Albany, NY, USA.

Myasthenia gravis, an autoimmune disorder of neuromuscular transmission, can lead to varying degrees of weakness and fatigability of the skeletal musculature. Juvenile myasthenia gravis accounts for 10-15% of all cases of myasthenia gravis. The clinical presentation of juvenile myasthenia gravis varies tremendously, which presents itself as a diagnostic challenge for clinicians. Read More

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December 2021

Successful treatment of refractory status asthmaticus with omalizumab: a case report.

Allergy Asthma Clin Immunol 2021 Dec 9;17(1):128. Epub 2021 Dec 9.

Dept. of Anesthesiology, Perioperative Medicine and Intensive Care, Masaryk Hospital, J.E. Purkinje University, Usti nad Labem, Czechia.

Refractory status asthmaticus is the cause of rare cases of in-hospital death due to acute bronchial asthma. The most severe cases unresponsive to first, second and next line treatment may be fatal despite aggressive organ support with invasive ventilation and extracorporeal membrane oxygenation. Omalizumab, a humanized recombinant monoclonal anti-IgE antibody, is an approved add-on biological treatment for severe asthma. Read More

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December 2021

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

Pediatr Pulmonol 2022 02 8;57(2):395-402. Epub 2021 Dec 8.

Section of Pulmonary Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.

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. Read More

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February 2022

Geospatial Analysis of Social Determinants of Health Identifies Neighborhood Hot Spots Associated With Pediatric Intensive Care Use for Life-Threatening Asthma.

J Allergy Clin Immunol Pract 2022 04 11;10(4):981-991.e1. Epub 2021 Nov 11.

Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Children's Healthcare of Atlanta at Egleston, Atlanta, GA.

Background: Social determinants of health are associated with asthma prevalence and healthcare use in children with asthma, but are multifactorial and complex. Whether social determinants similarly influence exacerbation severity is not clear.

Objective: Composite measures of social determinants of health and readmission outcomes were evaluated in a large regional cohort of 1,403 school-age children admitted to a pediatric intensive care unit (PICU) for asthma. Read More

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Evaluation of Real-Life Investigational Use of Enoximone in Asthma, the Third Step in Drug Repurposing: A Preliminary Report.

Can Respir J 2021 1;2021:7456208. Epub 2021 Nov 1.

Department of Pulmonary Medicine, Erasmus University Medical Center (Erasmus MC), Dr. Molewaterplein 50, 3015 GE Rotterdam, Netherlands.

Background: The population of uncontrolled asthma patients represents a large therapeutic burden. The PDE3-inhibitor enoximone is a strong and quick bronchodilator and is known to successfully treat life-threatening bronchial asthma (status asthmaticus). Translational mice models showed anti-inflammatory effects when PDE3 was targeted. Read More

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January 2022

Use of inhalational anaesthetic agents in paediatric and adult patients for status asthmaticus, status epilepticus and difficult sedation scenarios: a protocol for a systematic review.

BMJ Open 2021 11 10;11(11):e051745. Epub 2021 Nov 10.

Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.

Introduction: Inhaled volatile anaesthetics have a long tradition of use as hypnotic agents in operating rooms and are gaining traction as sedatives in intensive care units (ICUs). However, uptake is impeded by low familiarity with volatiles, unique equipment and education needs. Inhaled anaesthetics are often reserved in ICUs as therapies for refractory and life threatening status asthmaticus, status epilepticus, high and difficult sedation need scenarios given they possess unique pharmacological properties to manage these medical conditions while providing sedation to acutely ill patients. Read More

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November 2021

Dexamethasone Versus Prednisone in Children Hospitalized for Acute Asthma Exacerbations.

Hosp Pediatr 2021 11 5;11(11):1263-1272. Epub 2021 Oct 5.

Division of Hospital Medicine.

Background And Objectives: Extensive literature supports using dexamethasone (DEX) in children presenting to the emergency department (ED) with mild-to-moderate asthma exacerbations; however, only limited studies have assessed this in hospitalized children. In this study, we evaluate the outcomes of DEX versus prednisone/prednisolone (PRED) use in children hospitalized for mild-to-moderate asthma exacerbations.

Methods: This multisite retrospective cohort study included children between 3 and 21 years of age hospitalized to a tertiary care children's hospital system between January 1, 2013, and December 31, 2017, with a primary discharge diagnosis of acute asthma exacerbation or status asthmaticus. Read More

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November 2021