1,818 results match your criteria Status Asthmaticus


Pulmonary Barotrauma Including Huge Pulmonary Interstitial Emphysema in an Adult with Status Asthmaticus: Diagnostic and Therapeutic Challenges.

Eur J Case Rep Intern Med 2018 25;5(5):000823. Epub 2018 May 25.

Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia.

Introduction: Pulmonary interstitial emphysema is a rare finding defined as abnormal air collection inside the lung interstitial tissues. Described more frequently in ventilated new-borns, pulmonary interstitial emphysema is an uncommon barotrauma-related complication in adults. Management and clinical sequelae are poorly described. Read More

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https://www.ejcrim.com/index.php/EJCRIM/article/view/823
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http://dx.doi.org/10.12890/2018_000823DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346923PMC
May 2018
3 Reads

School Nurses on the Front Lines of Medicine: Emergencies Associated With Sport and Physical Activities: Part 1.

NASN Sch Nurse 2019 Feb 9:1942602X18819223. Epub 2019 Feb 9.

Professor, Departments of Emergency Medicine and Pediatrics, Penn State College of Medicine.

Illness and injury associated with sport and physical activities may occur in the school setting. Although most sport-related illness and injury in students are considered minor emergencies, life- and limb-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus, catastrophic brain or cervical spine injuries, hypoglycemia, blunt chest/abdominal injuries, or extremity fractures requiring surgery. It is important for the school nurse to recognize potential life- and limb-threatening emergencies associated with sport and physical activity, to initiate stabilization of the student with life- and limb-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow up at their primary healthcare provider's office, or directly to the closest emergency department via emergency medical services). Read More

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http://dx.doi.org/10.1177/1942602X18819223DOI Listing
February 2019
2 Reads

Predictors of Hospital Reuse Among Publicly Insured Children Hospitalized for Status Asthmaticus.

Hosp Pediatr 2019 Feb 4. Epub 2019 Feb 4.

Department of Pediatrics, School of Medicine and.

Background: Asthma is a common cause of pediatric hospitalization. Nonadherence to asthma medications is associated with worse outcomes; however, there is a paucity of data regarding posthospitalization prescription filling and hospital reuse. Our objective was to identify patients at risk for hospital reuse after being hospitalized for asthma. Read More

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http://dx.doi.org/10.1542/hpeds.2017-0239DOI Listing
February 2019
1 Read

Subdissociative Ketamine Use in the Emergency Department.

Adv Emerg Nurs J 2019 Jan/Mar;41(1):15-22

Emory University Hospital, Atlanta, Georgia (Dr Nichols); and Emory University Hospital Midtown, Atlanta, Georgia (Dr Paciullo).

Ketamine is an anesthetic known globally both for its potent dissociative properties and potential for abuse. More recently, ketamine demonstrates utility in a variety of disease states such as treatment-resistant depression, status asthmaticus, and acute agitation. In addition, ketamine has been shown to demonstrate various effects at different doses, which adds to its pharmacological benefit. Read More

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http://dx.doi.org/10.1097/TME.0000000000000222DOI Listing
February 2019
1 Read

The anatomic substrate of irreversible airway obstruction and barotrauma in a case of hurricane-triggered fatal status asthmaticus during puerperium: Lessons from an autopsy.

Respir Med Case Rep 2019 21;26:136-141. Epub 2018 Dec 21.

Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA.

Non-fully reversible airway obstruction in fatal asthma is often seen in association with profound structural changes of the bronchial wall, termed airway remodeling. Evidence suggests that heavy precipitation events can trigger epidemics of severe asthma. We present a case of fatal asthma in a young woman with no prior near-fatal exacerbations and postulate that the patient's extensive airway remodeling and puerperal state (susceptibility factors), in combination with a massive allergen challenge during a hurricane landfall (triggering factor), played a central role in her death. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22130071183038
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http://dx.doi.org/10.1016/j.rmcr.2018.12.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306954PMC
December 2018
3 Reads

Omalizumab Rescue Therapy for Refractory Status Asthmaticus.

Ann Intern Med 2018 Nov 20. Epub 2018 Nov 20.

Ludwig-Maximilians-University of Munich and Comprehensive Pneumology Center, Munich Germany (K.M., J.B., N.K.).

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http://dx.doi.org/10.7326/L18-0359DOI Listing
November 2018
1 Read

Refractory Status Asthmaticus: A Case for Unconventional Therapies.

Indian J Crit Care Med 2018 Oct;22(10):749-752

Department of Pediatric Emergency and Critical Care Unit, Institute of Child Health, Sir Ganga Ram Hospital, New Delhi, India.

Status Asthmaticus is a common reason for Emergency Room visits in children. Most of the asthma flares are successfully managed by use of β agonist and steroids. If these therapies fail to halt the progression of asthma, a number of medical therapies may be used to treat it. Read More

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http://www.ijccm.org/text.asp?2018/22/10/749/243587
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http://dx.doi.org/10.4103/ijccm.IJCCM_191_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201647PMC
October 2018
12 Reads

Clinical and economic burden of severe asthma: A French cohort study.

Respir Med 2018 Nov 2;144:42-49. Epub 2018 Oct 2.

Bichat Hospital, AP-HP, Inserm U1152 & Paris-Diderot Medical School, 46 Rue Henri Huchard, 75877, Paris, France.

Objective: To describe the clinical and economic burden of severe asthma in France over 12 months.

Methods: Data were retrieved from the observational, prospective "Cohorte Obstruction Bronchique et Asthme" (COBRA) cohort, which has enrolled nearly 1000 asthma patients since 2007 from throughout France. Patients undergoing treatment with GINA step-4 or 5 medications uninterruptedly for 12 months (thus defining "severe asthma") were identified and their clinical data used to describe the clinical burden of asthma (exacerbations, symptoms outside exacerbations, and level of asthma control). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09546111183030
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http://dx.doi.org/10.1016/j.rmed.2018.10.002DOI Listing
November 2018
11 Reads

Safety and effectiveness of albuterol solutions with and without benzalkonium chloride when administered by continuous nebulization.

Am J Health Syst Pharm 2018 Nov 3;75(22):1791-1797. Epub 2018 Oct 3.

Department of Emergency Medicine, University of Florida Health Shands Hospital, Gainesville, FL.

Purpose: The results of a study to determine if rates of poor response differ in patients receiving continuous nebulized albuterol (CNA) therapy with or without the preservative benzalkonium chloride are presented.

Methods: A retrospective analysis of the records of all patients who received CNA therapy at a large academic medical center from July 2015 to January 2016 was conducted. Data from patient evaluations performed before and after a change to benzalkonium chloride-containing albuterol were collected. Read More

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https://academic.oup.com/ajhp/article/75/22/1791-1797/522067
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http://dx.doi.org/10.2146/ajhp180154DOI Listing
November 2018
3 Reads

At-risk registers integrated into primary care to stop asthma crises in the UK (ARRISA-UK): study protocol for a pragmatic, cluster randomised trial with nested health economic and process evaluations.

Trials 2018 Aug 29;19(1):466. Epub 2018 Aug 29.

University of East Anglia, Norwich, UK.

Background: Despite effective treatments and long-standing management guidelines, there are approximately 1400 hospital admissions for asthma weekly in the United Kingdom (UK), many of which could be avoided. In our previous research, a secondary analysis of the intervention (ARRISA) suggested an improvement in the management of at-risk asthma patients in primary care. ARRISA involved identifying individuals at risk of adverse asthma events, flagging their electronic health records, training practice staff to develop and implement practice-wide processes of care when alerted by the flag, plus motivational reminders. Read More

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http://dx.doi.org/10.1186/s13063-018-2816-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116486PMC
August 2018
13 Reads

Successful Use of Extracorporeal Membrane Oxygenation for Status Asthmaticus in a Woman With a Periviable Pregnancy.

Obstet Gynecol 2018 Oct;132(4):1007-1010

Department of Obstetrics and Gynecology and the Division of Maternal-Fetal Medicine, Tufts Medical Center, Boston, Massachusetts.

Background: Status asthmaticus is a severe asthma exacerbation with persistent airway obstruction despite standard therapy. Use of extracorporeal membrane oxygenation (ECMO) as rescue therapy in pregnancy is exceedingly rare. We describe a case of ECMO for treatment of status asthmaticus in woman with a periviable pregnancy culminating in a term delivery. Read More

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http://dx.doi.org/10.1097/AOG.0000000000002799DOI Listing
October 2018
7 Reads

Inflammatory and Comorbid Features of Children Admitted to a PICU for Status Asthmaticus.

Pediatr Crit Care Med 2018 Nov;19(11):e585-e594

Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.

Objectives: To determine risk factors associated with admission to a PICU with or without endotracheal intubation for an asthma exacerbation. We hypothesized that children with critical and near-fatal asthma would have distinguishing clinical features but varying degrees of asthma severity and measures of type 2 inflammation.

Design: Retrospective analysis of prospectively collected data of children with asthma recruited into outpatient asthma clinical research studies at Emory University between 2004 and 2015. Read More

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http://dx.doi.org/10.1097/PCC.0000000000001695DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218278PMC
November 2018
2 Reads

Pleth Variability Index to Assess Course of Illness in Children with Asthma.

J Emerg Med 2018 08 7;55(2):179-184. Epub 2018 Jul 7.

Division of Critical Care Medicine, Children's Hospital at Montefiore/Albert Einstein School of Medicine, Bronx, New York.

Background: Status asthmaticus (SA) is a common reason for admission to the pediatric emergency department (ED). Assessing asthma severity efficiently in the ED can be challenging for clinicians. Adjunctive tools for the clinician have demonstrated inconsistent results. Read More

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http://dx.doi.org/10.1016/j.jemermed.2018.04.058DOI Listing
August 2018
10 Reads

Difficult airway management in a child with fibrodysplasia ossificans progressiva in status asthmaticus.

J Clin Anesth 2018 12 21;51:8-9. Epub 2018 Jul 21.

Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington, United States of America. Electronic address:

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http://dx.doi.org/10.1016/j.jclinane.2018.07.004DOI Listing
December 2018
3 Reads

Characteristics and Outcomes of Children with Clinical History of Atopic Non-atopic Asthma Admitted to a Tertiary Pediatric Intensive Care Unit.

Open Respir Med J 2018 31;12:21-28. Epub 2018 May 31.

Department of Pediatrics Division of Pulmonary Medicine, University of Texas Health Science Center at Houston, Houston, USA.

Background: Children admitted to the Pediatric Intensive Care Unit (PICU) with status asthmaticus have variable clinical courses, and predicting their outcomes is challenging. Identifying characteristics in these patients that may require more intense intervention is important for clinical decision-making.

Objective: This study sought to determine the characteristics and outcomes, specifically length of stay and mortality, of atopic non-atopic asthmatics admitted to a PICU with status asthmaticus. Read More

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http://dx.doi.org/10.2174/1874306401812010021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008982PMC
May 2018
2 Reads

Antibiotics for exacerbations of asthma.

Cochrane Database Syst Rev 2018 06 25;6:CD002741. Epub 2018 Jun 25.

Cochrane Airways, Population Health Research Institute, St George's, University of London, London, UK, SW17 0RE.

Background: Asthma is a chronic respiratory condition that affects over 300 million adults and children worldwide. It is characterised by wheeze, cough, chest tightness, and shortness of breath. Symptoms typically are intermittent and may worsen over a short time, leading to an exacerbation. Read More

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http://doi.wiley.com/10.1002/14651858.CD002741.pub2
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http://dx.doi.org/10.1002/14651858.CD002741.pub2DOI Listing
June 2018
23 Reads

Use of Antihypertensive Medications and Uterotonics During Delivery Hospitalizations in Women With Asthma.

Obstet Gynecol 2018 Jul;132(1):185-192

Department of Obstetrics and Gynecology, College of Physicians and Surgeons, and the Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, New York.

Objective: To estimate whether the diagnosis of asthma is associated with the use of specific uterotonic and antihypertensive medications during delivery hospitalizations.

Methods: We used Perspective, an administrative database, to determine whether women hospitalized for delivery complicated by postpartum hemorrhage or preeclampsia received uterotonics and antihypertensive medications differentially based on the absence or presence of asthma from 2006 to 2015. Given that carboprost and intravenous (IV) labetalol may be associated with asthma exacerbation, adjusted models for receipt of these medications were created with adjusted risk ratios with 95% CIs as measures of effect. Read More

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http://dx.doi.org/10.1097/AOG.0000000000002685DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019174PMC
July 2018
11 Reads

Characteristics and outcomes of treatment in status asthmaticus patients at emergency department.

Asian Pac J Allergy Immunol 2018 Jun 11. Epub 2018 Jun 11.

Department of Emergency Medicine, Faculty of Medicine, Thammasat University (Rangsit Campus), Pathum Thani, Thailand.

Introduction: The characteristics and treatment outcomes of status asthmaticus patients in emergency department (ED) have not been described previously especially in Thailand.

Objective: To describe the characteristics, treatment outcomes and factors associated with status asthmaticus in Thai patients presenting to a single center ED.

Methods: A prospective observational study was performed at Thammasat University hospital, Thailand. Read More

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http://dx.doi.org/10.12932/AP-261217-0224DOI Listing
June 2018
11 Reads

Medication Regimens for Managing Acute Asthma.

Respir Care 2018 Jun;63(6):783-796

Department of Medicine, Division of Pulmonary Diseases and Critical Care, UT Health, San Antonio, Texas.

Asthma exacerbation is defined as a progressive increase in symptoms of shortness of breath, cough, or wheezing sufficient to require a change in therapy. After ruling out diagnoses that mimic an asthma exacerbation, therapy should be initiated. Short-acting β agonists and short-acting muscarinic antagonists are effective as bronchodilators for asthma in the acute setting. Read More

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http://rc.rcjournal.com/lookup/doi/10.4187/respcare.05953
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http://dx.doi.org/10.4187/respcare.05953DOI Listing
June 2018
28 Reads

An Assessment of Asthma Therapy in the Pediatric ICU.

Hosp Pediatr 2018 Jun;8(6):361-367

Department of Pediatrics, School of Medicine, University of Utah and Primary Children's Hospital, Salt Lake City, Utah; and.

Objectives: To describe asthma management, investigate practice variation, and describe asthma-associated charges and resource use during asthma management in the PICU.

Methods: Children ages 2 to 18 years treated for status asthmaticus in the PICU from 2008 to 2011 are included in this study. This is a retrospective, single-center, cohort study. Read More

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http://hosppeds.aappublications.org/lookup/doi/10.1542/hpeds
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http://dx.doi.org/10.1542/hpeds.2017-0003DOI Listing
June 2018
14 Reads

Effects of a PICU Status Asthmaticus De-Escalation Pathway on Length of Stay and Albuterol Use.

Pediatr Crit Care Med 2018 Jul;19(7):658-664

Department of Pulmonology, Children's Hospital of Buffalo, Buffalo, NY.

Objectives: Evaluate the effects of an asthma de-escalation clinical pathway on selected outcomes for patients admitted to a PICU with status asthmaticus.

Design: Time series quality improvement trial.

Setting: PICU in a tertiary care children's hospital. Read More

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http://Insights.ovid.com/crossref?an=00130478-900000000-9845
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http://dx.doi.org/10.1097/PCC.0000000000001551DOI Listing
July 2018
9 Reads

The effectiveness of magnesium sulfate for status asthmaticus outside the intensive care setting.

Pediatr Pulmonol 2018 Jul 16;53(7):866-871. Epub 2018 Apr 16.

Cooper Medical School of Rowan University, Camden, New Jersey.

Aim: Magnesium is an adjunctive therapy used in patients with status asthmaticus who do not respond to conventional therapy. The optimal time from initiation of therapy, to determination of response and administration of magnesium has not yet been resolved. Our objective was to determine if magnesium administered in the non-intensive care setting can decrease duration of continuous albuterol and hospital length of stay. Read More

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http://dx.doi.org/10.1002/ppul.24013DOI Listing
July 2018
3 Reads

Children with severe acute asthma admitted to Dutch PICUs: A changing landscape.

Pediatr Pulmonol 2018 Jul 10;53(7):857-865. Epub 2018 Apr 10.

Department of Pediatric Intensive Care, Erasmus Medical Centre, Sophia's Children Hospital, Rotterdam, The Netherlands.

The number of children requiring pediatric intensive care unit (PICU) admission for severe acute asthma (SAA) around the world has increased.

Objectives: We investigated whether this trend in SAA PICU admissions is present in the Netherlands.

Methods: A multicenter retrospective cohort study across all tertiary care PICUs in the Netherlands. Read More

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http://doi.wiley.com/10.1002/ppul.24009
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http://dx.doi.org/10.1002/ppul.24009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6032863PMC
July 2018
7 Reads

Early Administration of Venovenous Extracorporeal Life Support for Status Asthmaticus during Anaesthetic Induction: Case Report and Literature Review.

Authors:
Won Ho Chang

Open Med (Wars) 2018 15;13:17-21. Epub 2018 Mar 15.

Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul04401, Korea.

Here we report a case of a 40-year-old man who visited the emergency room with severe chest pain. He showed a Stanford type B aortic dissection on chest-computed tomography. Despite medical treatment and malperfusion of lower extremities, acute renal failure developed; hence thoracic endovascular aortic repair (TEVAR) was considered under general anaesthesia. Read More

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http://dx.doi.org/10.1515/med-2018-0003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850994PMC
March 2018
6 Reads

Extracorporeal membrane oxygenation (ECMO) for near-fatal asthma refractory to conventional ventilation.

BMJ Case Rep 2018 Mar 20;2018. Epub 2018 Mar 20.

Critical Care Unit, Royal Stoke University Hospital, Stoke on Trent, UK.

We describe a case of near-fatal asthma, treated successfully by initiation of extracorporeal membrane oxygenation (ECMO). A 29-year-old woman, known asthmatic on steroid inhalers, inhaled/nebulised bronchodilators, long-term oral prednisolone, theophylline and montelukast, presented with acute shortness of breath. She deteriorated following initial treatment with nebulised bronchodilators and magnesium sulfate requiring intubation and mechanical ventilation. Read More

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http://dx.doi.org/10.1136/bcr-2017-223276DOI Listing
March 2018
21 Reads

Asthma-related mortality in the United States, 1999 to 2015: A multiple causes of death analysis.

Ann Allergy Asthma Immunol 2018 Jun 13;120(6):614-619. Epub 2018 Mar 13.

Department of Internal Medicine, Howard University Hospital, Washington, DC.

Background: Asthma mortality based on the underlying cause of death (UCOD) underestimates disease burden.

Objective: To analyze asthma mortality in the United States from 1999 to 2015 and the pattern of reporting of asthma and its comorbidities in death certificates, using multiple cause of death (MCOD) records.

Methods: All 156,517 death certificates with any mention of asthma were analyzed for 1999 to 2015. Read More

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http://dx.doi.org/10.1016/j.anai.2018.03.005DOI Listing
June 2018
7 Reads

A Quality Improvement Intervention to Improve Inpatient Pediatric Asthma Controller Accuracy.

Hosp Pediatr 2018 Mar 13;8(3):127-134. Epub 2018 Feb 13.

Children's Hospital at Montefiore, Bronx, New York, New York.

Objectives: Our objective was to investigate if a rigorous quality improvement (QI) intervention could increase accuracy of pediatric asthma controller medications on discharge from an inpatient hospitalization.

Methods: Our interprofessional QI team developed interventions such as improving documentation and creating standardized language to ensure patients were discharged on an appropriate asthma controller medication and improve assessment of asthma symptom control. Each week of 2015-2016, the first 5 patients discharged with status asthmaticus from the pediatric wards were reviewed for documentation of the 6 asthma control questions and accuracy of the discharge controller therapy. Read More

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http://dx.doi.org/10.1542/hpeds.2017-0184DOI Listing
March 2018
37 Reads

A pathophysiological role of PDE3 in allergic airway inflammation.

JCI Insight 2018 Jan 25;3(2). Epub 2018 Jan 25.

Department of Pulmonary Medicine, Erasmus MC, 's-Gravendijkwal, Rotterdam, Netherlands.

Phosphodiesterase 3 (PDE3) and PDE4 regulate levels of cyclic AMP, which are critical in various cell types involved in allergic airway inflammation. Although PDE4 inhibition attenuates allergic airway inflammation, reported side effects preclude its application as an antiasthma drug in humans. Case reports showed that enoximone, which is a smooth muscle relaxant that inhibits PDE3, is beneficial and lifesaving in status asthmaticus and is well tolerated. Read More

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http://dx.doi.org/10.1172/jci.insight.94888DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821178PMC
January 2018
7 Reads

The age-related characteristics of adults with asthma who visited emergency departments in Korea from 2007 to 2012.

Allergy Asthma Proc 2018 Mar 28;39(2):136-142. Epub 2017 Nov 28.

Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.

Background: Understanding the patterns of emergency department (ED) visits of patients with asthma is important for disease control and prevention of exacerbations.

Objective: This study aimed to investigate the characteristics of adult patients who visited EDs because of their asthma.

Methods: Patients with asthma, ages ≥19 years old, who visited 117 EDs throughout Korea between January 2007 and December 2012 were identified in the National Emergency Department Information System (NEDIS) data base using the International Classification of Disease, 10th revision, codes J45 (asthma) and J46 (status asthmaticus). Read More

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http://dx.doi.org/10.2500/aap.2018.39.4108DOI Listing
March 2018
19 Reads

Non-invasive ventilation use in status asthmaticus: 16 years of experience in a tertiary intensive care.

Emerg Med Australas 2018 Apr 12;30(2):187-192. Epub 2017 Nov 12.

Critical Care Complex, Middlemore Hospital, Auckland, New Zealand.

Objective: To describe the use of non-invasive ventilation (NIV) in adults presenting with status asthmaticus to Middlemore Hospital Critical Care Complex (CCC, South Auckland, New Zealand) from 2000 to 2015.

Method: Retrospective review of all adult asthma admissions to the Hospital CCC between 2000 and 2015. Demographic, physiological, treatment data and blood gas results were recorded. Read More

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http://dx.doi.org/10.1111/1742-6723.12876DOI Listing
April 2018
21 Reads

Mechanically Ventilating the Severe Asthmatic.

J Intensive Care Med 2018 Sep 5;33(9):491-501. Epub 2017 Nov 5.

2 Department of Critical Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

The management of the critically ill patients with asthma can be rather challenging. Potentially devastating complications relating to this presentation include hypoxemia, worsening bronchospasm, pulmonary aspiration, tension pneumothorax, dynamic hyperinflation, hypotension, dysrhythmias, and seizures. In contrast to various other pathologies requiring mechanical ventilation, acute asthma is generally associated with better outcomes. Read More

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http://dx.doi.org/10.1177/0885066617740079DOI Listing
September 2018
24 Reads

Toxicity of inhaled agents after prolonged administration.

J Clin Monit Comput 2018 Aug 2;32(4):651-666. Epub 2017 Nov 2.

Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.

Inhaled anesthetics have been utilized mostly for general anesthesia in the operating room and oftentimes for sedation and for treatment of refractory status epilepticus and status asthmaticus in the intensive care unit. These contexts in the ICU setting are related to potential for prolonged administration wherein potential organ toxicity is a concern. Over the last decade, several clinical and animal studies of neurotoxicity attributable to inhaled anesthetics have been emerging, particularly in extremes of age. Read More

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http://dx.doi.org/10.1007/s10877-017-0077-0DOI Listing
August 2018
9 Reads

Extracorporeal membrane oxygenation (ECMO) and ultraprotective mechanical ventilation for near-fatal status asthmaticus.

Med Intensiva 2018 12 18;42(9):556-558. Epub 2017 Sep 18.

Servicio de Medicina Intensiva, Hospital Universitario Virgen del Rocío, Sevilla, España.

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http://dx.doi.org/10.1016/j.medin.2017.07.011DOI Listing
December 2018
7 Reads

Asthma Outcomes and Management During Pregnancy.

Chest 2018 Feb 1;153(2):515-527. Epub 2017 Sep 1.

Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL.

Asthma during pregnancy poses a common, increasingly prevalent threat to the health of women and their children. The present article reviews recent insights gained from the epidemiology of asthma during pregnancy, demonstrating the many short- and long-term risks to mother and fetus incurred by poorly controlled maternal asthma. We further discuss emerging evidence that active management of asthma during pregnancy can positively influence and perhaps completely mitigate these poor outcomes. Read More

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http://dx.doi.org/10.1016/j.chest.2017.08.029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815874PMC
February 2018
12 Reads

Years of life lost due to bronchial asthma in Poland between 1999 and 2013.

J Asthma 2018 Jun 5;55(6):668-674. Epub 2017 Sep 5.

a Department of Epidemiology and Biostatistics , Medical University of Lodz , Łódź , Poland.

Objective: The aim of this study was to analyze the years of life lost due to asthma in Poland between 1999 and 2013, with the use of the SEYLL measure (Standard Expected Years of Life Lost).

Methods: The study was based on a dataset of 5,606,516 records gathered from death certificates of Polish residents from 1999 to 2013. The data on the deaths due to bronchial asthma and status asthmaticus (J45 and J46 according to ICD-10) were used for the analysis. Read More

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http://dx.doi.org/10.1080/02770903.2017.1355382DOI Listing
June 2018
16 Reads

Adjunctive extracorporeal carbon dioxide removal in refractory status asthmaticus.

BMJ Case Rep 2017 Jul 27;2017. Epub 2017 Jul 27.

Department of Telehealth, Northwell Health, Syosset, New York, USA.

Status asthmaticus (SA) is a life-threatening disorder. Severe respiratory failure may require extracorporeal membrane oxygenation (ECMO). Previous reports have demonstrated utility of ECMO in SA in various patients with varying success. Read More

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http://dx.doi.org/10.1136/bcr-2017-220693DOI Listing
July 2017
14 Reads

High variability of treatments for paediatric status asthmaticus: a retrospective study in PICUs.

Intensive Care Med 2017 11 20;43(11):1735-1737. Epub 2017 Jun 20.

PICU, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris Diderot-Paris 7 University 48, boulevard Sérurier, 75019, Paris, France.

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http://dx.doi.org/10.1007/s00134-017-4864-3DOI Listing
November 2017
6 Reads

An Unusual Complication With the Administration of a Volatile Anesthetic Agent for Status Asthmaticus in the Pediatric Intensive Care Unit: Case Report and Review of the Literature.

J Intensive Care Med 2017 Jul;32(6):400-404

2 Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA.

In severe cases of status asthmaticus, when conventional therapies fail, volatile anesthetic agents remain a therapeutic option. When delivered outside of the operating room setting, specialized delivery techniques are needed to ensure the safe and effective use of volatile anesthetic agents. We present a 16-year-old adolescent with status asthmaticus who required the therapeutic administration of the volatile anesthetic agent, sevoflurane, in the pediatric intensive care unit (PICU). Read More

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http://journals.sagepub.com/doi/10.1177/0885066617713169
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http://dx.doi.org/10.1177/0885066617713169DOI Listing
July 2017
37 Reads

Dexmedetomidine for Sedation During Noninvasive Ventilation in Pediatric Patients.

Pediatr Crit Care Med 2017 Sep;18(9):831-837

1Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH. 2Emory Sleep Center, Emory University, Atlanta, GA. 3Critical Care Medicine, Children's Healthcare of Atlanta, Children's at Egleston, Atlanta, GA. 4Biostatistics Core, The Research Institute at Nationwide Children's Hospital, Columbus, OH. 5Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH. 6Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH.

Objectives: To describe the use of dexmedetomidine for sedation in a large cohort of nonintubated children with acute respiratory insufficiency receiving noninvasive ventilatory support.

Design: Single-center, retrospective, observational cohort study.

Setting: A large quaternary-care PICU. Read More

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http://dx.doi.org/10.1097/PCC.0000000000001226DOI Listing
September 2017
17 Reads

High-Flow Nasal Cannula Utilization in Pediatric Critical Care.

Respir Care 2017 Aug 6;62(8):1023-1029. Epub 2017 Jun 6.

Division of Pediatric Critical Care, Department of Pediatrics, University of Maryland, Baltimore, Maryland.

Background: High-flow nasal cannula (HFNC) is increasingly utilized in pediatrics, delivering humidified air and oxygen for respiratory conditions causing hypoxia and distress. In the neonatal ICU, it has been associated with better tolerance, lower complications, and lower cost. Few data exist regarding indications for use and the epidemiology of disease/pathology that warrants HFNC in the pediatric ICU. Read More

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http://dx.doi.org/10.4187/respcare.05153DOI Listing
August 2017
47 Reads

A Case of Sevoflurane Use during Pregnancy in the Management of Persistent Status Asthmaticus.

Case Rep Obstet Gynecol 2017 7;2017:3547242. Epub 2017 May 7.

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.

Background: Sevoflurane is rarely used for the treatment of status asthmaticus. We report a case of sevoflurane hepatotoxicity in pregnancy with presentation similar to HELLP syndrome.

Case: A G2P1001 at 23 weeks in status asthmaticus presented with pCO2 > 130 and pH < 7. Read More

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http://dx.doi.org/10.1155/2017/3547242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438830PMC
May 2017
15 Reads

Adjunct Therapies for Refractory Status Asthmaticus in Children.

Authors:
Kyle J Rehder

Respir Care 2017 Jun;62(6):849-865

Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina.

Asthma exacerbation is a common reason for children to present to the emergency department. If primary therapies fail to halt the progression of an asthma flare, status asthmaticus often leads to hospital, and potentially ICU, admission. Following the initial administration of inhaled β agonists and systemic corticosteroids, a wide array of adjunct medical therapies may be used to treat status asthmaticus. Read More

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http://dx.doi.org/10.4187/respcare.05174DOI Listing
June 2017
15 Reads

Critical Care Interventions for Asthmatic Patients Admitted From the Emergency Department to the Pediatric Intensive Care Unit.

Pediatr Emerg Care 2018 Jun;34(6):385-389

From the Department of Pediatrics, Division of Pediatric Emergency Medicine, Saint Louis University School of Medicine and SSM Cardinal Glennon Children's Medical Center, Saint Louis, MO.

Objectives: The aim of this study was to assess the frequency and predictors of critical interventions in asthmatic patients admitted to the pediatric intensive care unit (PICU) at a tertiary-care pediatric hospital.

Methods: We conducted a retrospective chart review of patients admitted from our emergency department (ED) to the PICU for treatment of status asthmaticus between January 1, 2008, and March 31, 2013. Patients with concomitant medical conditions and those who received a critical intervention, other than continuously aerosolized albuterol, in the ED before admission were excluded. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001163DOI Listing
June 2018
49 Reads

Nasal high flow in management of children with status asthmaticus: a retrospective observational study.

Ann Intensive Care 2017 Dec 22;7(1):55. Epub 2017 May 22.

Réanimation pédiatrique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500, Bron, France.

Background: Asthma is the most common obstructive airway disease in children and adults. Nasal high flow (NHF) is a recent device that is now used as a primary support for respiratory distress. Several studies have reported use of NHF as a respiratory support in status asthmaticus; however, there are no data to recommend such practice. Read More

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http://dx.doi.org/10.1186/s13613-017-0278-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440424PMC
December 2017
45 Reads

[Extracorporeal membrane oxygenation in critically ill neonates and children].

Arch Pediatr 2017 Jun 14;24(6):578-586. Epub 2017 Apr 14.

Service de réanimation néonatale et pédiatrique, CHU d'Armand-Trousseau, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France; Unité Inserm U1141, hôpital Robert-Debré, 75019 Paris, France.

Extracorporeal membrane oxygenation is used as a last resort during neonatal and pediatric resuscitation in case of refractory circulatory or respiratory failure under maximum conventional therapies. Different types of ECMO can be used depending on the initial failure. The main indications for ECMO are refractory respiratory failure (acute respiratory distress syndrome, status asthmaticus, severe pneumonia, meconium aspiration syndrome, pulmonary hypertension) and refractory circulatory failure (cardiogenic shock, septic shock, refractory cardiac arrest). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0929693X173013
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http://dx.doi.org/10.1016/j.arcped.2017.03.001DOI Listing
June 2017
14 Reads

Asthma exacerbations among asthmatic children receiving live attenuated versus inactivated influenza vaccines.

Vaccine 2017 05 9;35(20):2668-2675. Epub 2017 Apr 9.

Kaiser Permanente Vaccine Study Center and Division of Research, Kaiser Permanente Medical Care Program, Northern California Region, Oakland, CA, United States.

Objective: To investigate whether there is a difference in the risk of asthma exacerbations between children with pre-existing asthma who receive live attenuated influenza vaccine (LAIV) compared with inactivated influenza vaccine (IIV).

Material And Methods: We identified IIV and LAIV immunizations occurring between July 1, 2007 and March 31, 2014 among Kaiser Permanente Northern California members aged 2 to <18years with a history of asthma, and subsequent asthma exacerbations seen in the inpatient or Emergency Department (ED) setting. We calculated the ratio of the odds (OR) of an exacerbation being in the risk interval (1-14days) versus the comparison interval (29-42days) following immunization, separately for LAIV and IIV, and then examined whether the OR differed between children receiving LAIV and those receiving IIV ("difference-in-differences"). Read More

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http://dx.doi.org/10.1016/j.vaccine.2017.03.082DOI Listing
May 2017
21 Reads

Status Asthmaticus and Central Herniation: A Case for Multidisciplinary Critical Care.

A A Case Rep 2017 Jun;8(11):286-290

From the Departments of *Anesthesiology and Perioperative Medicine, †Neurosurgery, and ‡Pulmonary and Critical Care Medicine, Oregon Health and Sciences University, Portland, Oregon; and §Anesthesiology, Columbia University, New York, New York.

A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000491DOI Listing
June 2017
12 Reads

Halogenated volatile anesthetics in the intensive care unit: current knowledge on an upcoming practice.

Minerva Anestesiol 2017 Jul 8;83(7):737-748. Epub 2017 Mar 8.

Department of Intensive Care, Faculty of Medicine, UDELAR, Hospital de Clínicas (Hôpital Universitaire), Montevideo, Uruguay.

The aim of this narrative review was to highlight key points of volatile anesthetics administration in the intensive care unit (ICU), including AnaConDa® and Mirus® devices characteristics and the reported findings on clinical outcomes in critically ill patients. Intravenous sedation in the ICU is associated with issues, such as over- and under-sedation. Halogenated compounds, which can be safely administered by inserting a device in any ICU ventilation circuit, have interesting pharmacodynamic and pharmacokinetic profiles for patients with multi-organ failure. Read More

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http://dx.doi.org/10.23736/S0375-9393.17.11735-9DOI Listing
July 2017
15 Reads

Pediatric asthma severity score is associated with critical care interventions.

World J Clin Pediatr 2017 Feb 8;6(1):34-39. Epub 2017 Feb 8.

Danielle K Maue, Courtney M Rowan, Department of Pediatric Critical Care, Indiana University School of Medicine, Indianapolis, IN 46202, United States.

Aim: To determine if a standardized asthma severity scoring system (PASS) was associated with the time spent on continuous albuterol and length of stay in the pediatric intensive care unit (PICU).

Methods: This is a single center, retrospective chart review study at a major children's hospital in an urban location. To qualify for this study, participants must have been admitted to the PICU with a diagnosis of status asthmaticus. Read More

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http://dx.doi.org/10.5409/wjcp.v6.i1.34DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296627PMC
February 2017
23 Reads