1,877 results match your criteria Status Asthmaticus


Trends in Intravenous Magnesium Use and Outcomes for Status Asthmaticus in Children's Hospitals from 2010 to 2017.

J Hosp Med 2020 Jun 17. Epub 2020 Jun 17.

Division of Pediatric Hospital Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Intravenous (IV) magnesium is used as an adjunct therapy in management of status asthmaticus with a goal of reducing intubation rate. A recent review suggests that IV magnesium use in status asthmaticus reduces admission rates. This is contrary to the observation of practicing emergency room physicians. Read More

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http://dx.doi.org/10.12788/jhm.3405DOI Listing

Unsuspected foreign-body aspiration in adult patient with status asthmaticus: Case report.

Ann Med Surg (Lond) 2020 Aug 8;56:1-4. Epub 2020 Jun 8.

Department of Critical Care Medicine, Fundación Valle del Lili, Cali, Colombia.

Introduction: Accidental foreign body aspiration can cause severe damage to the airway and threaten the patient's life. This situation requires multidisciplinary and systematic approach from the medical and surgical team, in order to achieve complete resolution maintaining airway permeability.

Presentation Of Case: This is a 49 y/o man who presented with a severe asthma attack, in whom an unsuspected foreign body in the inferior airway was diagnosed, which was possibly the result of aspiration during the initial emergency care, causing worsening of the already critical condition. Read More

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http://dx.doi.org/10.1016/j.amsu.2020.05.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292887PMC

Burden of Asthma in Elderly Japanese Patients: Using Hospital-Based Administrative Claims Data.

Pulm Ther 2020 Jun 5. Epub 2020 Jun 5.

Value Evidence Outcomes, Japan Development Division, GSK K.K., Tokyo, Japan.

Introduction: Data are lacking on severe asthma burden in elderly people in Japan. We assessed the prevalence and clinical/economic burden of severe asthma and asthma-related hospitalizations in elderly and younger Japanese patients.

Methods: This retrospective study analyzed outpatient claims data and inpatient hospital discharge records among patients aged ≥ 15 years with asthma (defined as ≥ 2 prescriptions of inhaled corticosteroids [ICS] or ICS/long-acting beta-agonists [LABA]) between 1 July 2014 and 30 June 2017. Read More

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http://dx.doi.org/10.1007/s41030-020-00121-wDOI Listing

Neuromuscular blockade management in the critically Ill patient.

J Intensive Care 2020 24;8:37. Epub 2020 May 24.

3Department of Anesthesiology, University of Minnesota Medical School, Minneapolis, MN USA.

Neuromuscular blocking agents (NMBAs) can be an effective modality to address challenges that arise daily in the intensive care unit (ICU). These medications are often used to optimize mechanical ventilation, facilitate endotracheal intubation, stop overt shivering during therapeutic hypothermia following cardiac arrest, and may have a role in the management of life-threatening conditions such as elevated intracranial pressure and status asthmaticus (when deep sedation fails or is not tolerated). However, current NMBA use has decreased during the last decade due to concerns of potential adverse effects such as venous thrombosis, patient awareness during paralysis, development of critical illness myopathy, autonomic interactions, and even residual paralysis following cessation of NMBA use. Read More

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http://dx.doi.org/10.1186/s40560-020-00455-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245849PMC

Escalation in Therapy Based on Intravenous Magnesium Sulfate Dosing in Pediatric Patients With Asthma Exacerbations.

J Pediatr Pharmacol Ther 2020 ;25(4):314-319

Objective: Our objective was to compare doses of intravenous magnesium sulfate and their association with escalations in therapy in children and adolescents presenting to the emergency department with an asthma exacerbation.

Methods: This was a retrospective cohort study among children who received both magnesium sulfate and standard of care therapy for asthma exacerbations. A classification and regression tree (CART) analysis was performed to identify a breakpoint in dose in which a difference in the primary outcome was present. Read More

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http://dx.doi.org/10.5863/1551-6776-25.4.314DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243902PMC
January 2020

Terbutaline and aminophylline as second-line therapies for status asthmaticus in the pediatric intensive care unit.

Pediatr Pulmonol 2020 Jul 19;55(7):1624-1630. Epub 2020 May 19.

Section of Pediatric Critical Care, Department of Pediatrics, University of Chicago, Chicago, Illinois.

Objective: Asthma is the most common chronic disease of childhood. Although asthma admissions to the pediatric intensive care unit (PICU) are increasing, there are no evidence-based guidelines on preferred escalation of therapies for patients with status asthmaticus who fail to respond to inhaled bronchodilators and systemic corticosteroids. The purpose of this study was to assess outcomes of PICU patients receiving aminophylline versus terbutaline as second-tier therapies for status asthmaticus. Read More

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http://dx.doi.org/10.1002/ppul.24821DOI Listing

SCAMP-ering Toward Improved Quality of Care in Children With Status Asthmaticus.

Pediatr Crit Care Med 2020 05;21(5):499-500

Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT.

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http://dx.doi.org/10.1097/PCC.0000000000002245DOI Listing

The Reemergence of Ketamine for Treatment in Critically Ill Adults.

Crit Care Med 2020 Jun;48(6):899-911

Department of Pharmacy, ProMedica Toledo Hospital/Toledo Children's Hospital, Toledo, OH.

Objectives: To assess the evidence and discuss the risks and clinical relevance of ketamine for the treatment of various disease states impacting the adult critically ill population.

Data Sources: A literature review was performed using PubMed evaluating primary literature published until August 2018.

Study Selection: Case reports, observational studies (cohort, case-control), and randomized controlled trials involving patients 18 years and older in a nonperioperative setting using either IV or intramuscular ketamine were included for analysis. Read More

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http://dx.doi.org/10.1097/CCM.0000000000004335DOI Listing

Enoximone in status asthmaticus.

ERJ Open Res 2020 Jan 6;6(1). Epub 2020 Apr 6.

Dept of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.

http://bit.ly/38UYpUn. Read More

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http://dx.doi.org/10.1183/23120541.00367-2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132035PMC
January 2020

Residential instability, neighborhood deprivation, and pediatric asthma outcomes.

Pediatr Pulmonol 2020 Jun 10;55(6):1340-1348. Epub 2020 Apr 10.

Department of Pediatrics, Division of Pediatric Pulmonary and Sleep Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

Introduction: Limited work has directly compared the role of different neighborhood factors or examined their interactive effects on pediatric asthma outcomes. Our objective was to quantify the main and interactive effects of neighborhood deprivation and residential instability (RI) on pediatric asthma outcomes.

Methods: We conducted a retrospective cross-sectional study of patients with a primary diagnosis of asthma hospitalized at a tertiary care pediatric hospital. Read More

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http://dx.doi.org/10.1002/ppul.24771DOI Listing

Extracorporeal and advanced therapies for progressive refractory near-fatal acute severe asthma in children.

Pediatr Pulmonol 2020 Jun 30;55(6):1311-1319. Epub 2020 Mar 30.

Division of Pulmonary and Sleep Medicine, Children's National Health System, George Washington University School of Medicine and Health Sciences, Washington, DC.

Asthma is the most common chronic illness and is one of the most common medical emergencies in children. Progressive refractory near-fatal asthma requiring intubation and mechanical ventilation can lead to death. Extracorporeal membrane oxygenation (ECMO) can provide adequate gas exchange during acute respiratory failure although data on outcomes in children requiring ECMO support for status asthmaticus is sparse with one study reporting survival rates of nearly 85% with asthma being one of the best outcome subsets for patients with refractory respiratory failure requiring ECMO support. Read More

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http://dx.doi.org/10.1002/ppul.24751DOI Listing

Age- and gender-specific trends in respiratory outpatient visits and diagnoses at a tertiary pediatric hospital in China: a 10-year retrospective study.

BMC Pediatr 2020 Mar 12;20(1):115. Epub 2020 Mar 12.

Pediatric Heart Center, Children's Hospital of Fudan University, Shanghai, China.

Background: Respiratory infections are one of three leading causes of childhood mortality, and worldwide increase and recent plateau in childhood asthma has been reported. However, data on trends of respiratory diseases over long period of time is limited. This study aimed to determine the trends of respiratory disease outpatient visits (ROVs) and diagnoses (RODs) in one of the largest children's teaching hospitals in China between 2009 and 2018. Read More

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http://dx.doi.org/10.1186/s12887-020-2001-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068978PMC

Improving Influenza Vaccination in Hospitalized Children With Asthma.

Pediatrics 2020 03;145(3)

Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.

Objectives: Children with asthma are at increased risk of complications from influenza; hospitalization represents an important opportunity for vaccination. We aimed to increase the influenza vaccination rate among eligible hospitalized patients with asthma on the pediatric hospital medicine (PHM) service from 13% to 80% over a 4-year period.

Methods: Serial Plan-Do-Study-Act cycles were implemented to improve influenza vaccination rates among children admitted with status asthmaticus and included modifications to the electronic health record (EHR) and provider and family education. Read More

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http://dx.doi.org/10.1542/peds.2019-1735DOI Listing

Standardized Protocol Is Associated With a Decrease in Continuous Albuterol Use and Length of Stay in Critical Status Asthmaticus.

Pediatr Crit Care Med 2020 05;21(5):451-460

Division of Medicine Critical Care, Boston Children's Hospital, Harvard Medical School Boston, MA.

Objectives: The primary aim of this study was to reduce duration of continuous albuterol and hospital length of stay in critically ill children with severe status asthmaticus.

Design: Observational prospective study from September 2012 to May 2016.

Setting: Medicine ICU and intermediate care unit. Read More

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http://dx.doi.org/10.1097/PCC.0000000000002239DOI Listing

Treatment of Open-Angle Glaucoma and Ocular Hypertension with Preservative-Free Tafluprost/Timolol Fixed-Dose Combination Therapy: The VISIONARY Study.

Adv Ther 2020 Apr 18;37(4):1436-1451. Epub 2020 Feb 18.

Department of Ophthalmology, Semmelweis University, Budapest, Hungary.

Introduction: A non-interventional, multicenter, European, prospective evaluation of the effectiveness, tolerability, and safety of a topical preservative-free tafluprost (0.0015%) and timolol (0.5%) fixed-dose combination (PF tafluprost/timolol FC) in adults with open-angle glaucoma (OAG) and ocular hypertension (OHT) demonstrating insufficient response to topical beta-receptor blockers or prostaglandin analogue (PGA) monotherapy. Read More

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http://dx.doi.org/10.1007/s12325-020-01239-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140739PMC

Initial Modified Pulmonary Index Score Predicts Hospital Length of Stay for Asthma Subjects Admitted to the Pediatric Intensive Care Unit.

Respir Care 2020 Feb 18. Epub 2020 Feb 18.

Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina.

Background: Scoring systems are frequently used to assess the severity of pediatric asthma exacerbations. The modified pulmonary index score (MPIS) has been found to be highly correlated with length of stay (LOS) in the pediatric intensive care unit (PICU). We sought to evaluate the use of the MPIS to predict hospital LOS for patients admitted to our PICU. Read More

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http://dx.doi.org/10.4187/respcare.07396DOI Listing
February 2020

Extracorporeal carbon dioxide removal in heart-beating donor with acute severe asthma: A case report.

Respir Med Case Rep 2020 28;29:101010. Epub 2020 Jan 28.

International Renal Research Institute of Vicenza, Vicenza, Italy.

Status asthmaticus is a life-threatening disorder that can manifest in dangerous levels of hypercapnia and acidosis. The use of extracorporeal carbon dioxide removal (ECCO2R) has been used successfully to control pH and PaCO in patients with acute severe asthma. The present report describes the use of this technology in near-fatal asthma with brain death, and awaiting organ harvest. Read More

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http://dx.doi.org/10.1016/j.rmcr.2020.101010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997904PMC
January 2020

Continuous Albuterol in Pediatric Acute Care: Study Demonstrates Safety Outside the Intensive Care Unit.

Pediatr Qual Saf 2019 Nov-Dec;4(6):e225. Epub 2019 Dec 5.

Division of Hospital Medicine, Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, Tex.

There are little data to support the use of continuous aerosolized albuterol (CAA) in the non-intensive care unit (ICU) or non-emergency department (ED) setting for pediatric asthma patients. A 2014 study demonstrated low rates of adverse outcomes associated with administration of CAA on the acute care unit; however, the authors do not describe additional outcomes. We sought to determine whether administration of CAA within a respiratory cohort on an acute care floor was feasible and safe. Read More

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http://dx.doi.org/10.1097/pq9.0000000000000225DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946228PMC
December 2019

Association of various weight-based doses of continuous albuterol on hospital length of stay.

J Asthma 2020 Feb 6:1-6. Epub 2020 Feb 6.

Division of Pediatric Hospital Medicine, Department of Pediatrics, McGovern Medical School, Houston, TX, USA.

Continuous albuterol is a mainstay in management of pediatric status asthmaticus. While the National Heart Lung and Blood Institute Asthma Guidelines suggest 0.5 mg/kg/h as the recommended dosage, there is a paucity of evidence comparing different weight-based rates on hospital outcomes. Read More

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http://dx.doi.org/10.1080/02770903.2020.1723622DOI Listing
February 2020

Recurrent endobronchial inflammatory myofibroblastic tumors: Novel treatment options.

Pediatr Pulmonol 2020 03 27;55(3):788-790. Epub 2020 Jan 27.

Division of Pediatric Pulmonology, Department of Pediatrics, CS Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor, Michigan.

Endobronchial inflammatory myofibroblastic tumors (IMTs) rarely occur in children younger than 10 years of age and have intermediate malignant potential. A 7-year-old girl initially presented with pneumonia. After failing outpatient treatment, she re-presented in status asthmaticus. Read More

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http://dx.doi.org/10.1002/ppul.24666DOI Listing

Outcome of status asthmaticus at a pediatric intensive care unit in Hong Kong.

Clin Respir J 2020 May 14;14(5):462-470. Epub 2020 Feb 14.

Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Objectives: To characterize the clinical course and outcome of children with status asthmaticus (SA) admitted to a pediatric intensive care unit (PICU) METHODS: All patients with SA who were admitted to a PICU from January 2003 to December 2018 were reviewed. Polymerase chain reaction (PCR) studies on nasopharyngeal aspirate for respiratory pathogens were performed from 2014 to 2018.

Results: Sixty-seven SA admissions constituted 2. Read More

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http://dx.doi.org/10.1111/crj.13154DOI Listing

Volatile anaesthetic for treatment of respiratory failure from status asthmaticus requiring extracorporeal membrane oxygenation.

BMJ Case Rep 2020 Jan 15;13(1). Epub 2020 Jan 15.

Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA

A 37-year-old male smoker with asthma presented with status asthmaticus refractory to terbutaline, intravenous magnesium, continuous bronchodilators, steroids, heliox and theophylline infusion. He was intubated on hospital day 2 and cannulated for veno-venous extracorporeal membrane oxygenation (V-V ECMO) on hospital day 3 for refractory respiratory acidosis secondary to hypercapnia and hypoxemia despite maximum medical management over 4 days. He was started on inhaled isoflurane with improvement in peak airway pressures and respiratory acidosis, allowing for prompt weaning from V-V ECMO and extubation. Read More

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http://dx.doi.org/10.1136/bcr-2019-231507DOI Listing
January 2020

Oral Dexamethasone vs. Oral Prednisone for Children With Acute Asthma Exacerbations: A Systematic Review and Meta-Analysis.

Front Pediatr 2019 13;7:503. Epub 2019 Dec 13.

Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying, China.

This systematic review and meta-analysis was conducted to compare relapse rates and adverse effects with oral dexamethasone vs. oral prednisone for acute asthma exacerbations in pediatric patients. A computerized literature search of PubMed, Embase, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials) and Google scholar databases was carried out till 1st August 2019. Read More

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http://dx.doi.org/10.3389/fped.2019.00503DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923200PMC
December 2019

A winter to remember! Extracorporeal membrane oxygenation for life-threatening asthma in children: A case series and review of literature.

Pediatr Pulmonol 2020 02 20;55(2):E1-E4. Epub 2019 Dec 20.

Department of Pediatric Cardiothoracic Surgery, Shand's Children's Hospital, University of Florida, Gainsville, Florida.

Progressive refractory near-fatal asthma requiring intubation and mechanical ventilation can lead to death. Data on outcomes in children requiring extracorporeal membrane oxygenation (ECMO) support for status asthmaticus is sparse. We describe our experience of three patients in the winter of 2018 to 2019 successfully rescued with ECMO. Read More

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http://dx.doi.org/10.1002/ppul.24616DOI Listing
February 2020

Current practices in children with severe acute asthma across European PICUs: an ESPNIC survey.

Eur J Pediatr 2020 Mar 3;179(3):455-461. Epub 2019 Dec 3.

Department of Pediatric Intensive Care Unit/Pediatric Surgery, Erasmus Medical Centre, Sophia's Children Hospital, PO Box 2060, 3000CB, Rotterdam, The Netherlands.

Most pediatric asthma guidelines offer evidence-based or best practice approaches to the management of asthma exacerbations but struggle with evidence-based approaches for severe acute asthma (SAA). We aimed to investigate current practices in children with SAA admitted to European pediatric intensive care units (PICUs), in particular, adjunct therapies, use of an asthma severity score, and availability of a SAA guideline. We designed a cross-sectional electronic survey across European PICUs. Read More

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http://dx.doi.org/10.1007/s00431-019-03502-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028840PMC

Medication Confiscation: How Migrant Children Are Placed in Medically Vulnerable Conditions.

Pediatrics 2020 01 3;145(1). Epub 2019 Dec 3.

Stony Brook University Children's Hospital, Stony Brook, New York

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http://dx.doi.org/10.1542/peds.2019-2524DOI Listing
January 2020

Refractory Status Asthmaticus: Treatment With Sevoflurane.

Fed Pract 2019 Oct;36(10):476-479

is a Pulmonary/Critical Care Medicine Physician at the George E. Whalen VA Medical Center and an Assistant Professor of Medicine at the University of Utah in Salt Lake City. is a Medical Director of Flight for Life and Pulmonary/Critical Care Medicine Physician at Christus Trinity Mother Frances Health System in Tyler, Texas.

A patient with life-threatening asthma and status asthmaticus was treated with sevoflurane general anesthesia. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837338PMC
October 2019

Acute severe asthma (status asthmaticus).

Allergy Asthma Proc 2019 11;40(6):406-409

Acute severe asthma, formerly known as status asthmaticus, is defined as severe asthma unresponsive to repeated courses of beta-agonist therapy. It is a medical emergency that requires immediate recognition and treatment. Albuterol in combination with ipratropium bromide in the emergency department (ED) has been shown to decrease the time spent in the ED and the hospitalization rates. Read More

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http://dx.doi.org/10.2500/aap.2019.40.4258DOI Listing
November 2019

High frequency percussive ventilation as a rescue mode for refractory status asthmaticus - a case study.

J Asthma 2019 Nov 6:1-4. Epub 2019 Nov 6.

Winchester Medical Center, Winchester, VA, USA.

A severe asthma exacerbation is called status asthmaticus when symptoms worsen despite conventional medical treatment in the hospital. If arterial blood gas (ABG) values deteriorate and this is accompanied by respiratory muscle fatigue, the patient will require mechanical ventilation. However, mechanical ventilation of the severe asthmatic presents difficult challenges. Read More

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http://dx.doi.org/10.1080/02770903.2019.1687714DOI Listing
November 2019
1 Read

Pediatric asthma severity scores distinguish suitable inpatient level of care for children admitted for status asthmaticus.

J Asthma 2019 Oct 26:1-9. Epub 2019 Oct 26.

Johns Hopkins All Children's Hospital , St. Petersburg , FL , USA.

To determine if the Pediatric Asthma Severity Score (PASS) can distinguish "late-rescues" (transfer to the pediatric intensive care unit [PICU] within 24-hours of general pediatric floor admission), "PICU readmissions" (readmission within 24-h after transfer to a lower inpatient level of care), and unplanned 30-day hospital readmission in children admitted with status asthmaticus. We performed a single center, retrospective cohort study in 328 children admitted for asthma exacerbation aged 5-18 years from May 2015 to October 2017. We sought to determine if PASS values preceding admission from the emergency department or transfer to the general pediatric unit will be greater in children with late rescues and PICU readmissions and if a cutoff PASS values exist to discriminate these events prior to intrafacility transfer. Read More

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http://dx.doi.org/10.1080/02770903.2019.1680998DOI Listing
October 2019
1 Read

Procalcitonin Levels in Critically Ill Children With Status Asthmaticus.

Pediatr Emerg Care 2019 Oct;35(10):671-674

Critical Care Medicine, Cincinnati Children's Hospital Medical Center.

Background: Children with status asthmaticus (SA) often present with fever and are evaluated with chest radiographs (CXRs). In the absence of a confirmatory test for bacterial infection, antibiotics are started whenever there are radiological infiltrates or if there is a suspicion of pneumonia. We undertook this study to determine if serum procalcitonin (PCT) levels at admission are altered in critically ill children with SA. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001259DOI Listing
October 2019
1 Read

Tonsillectomy does not reduce asthma in children: A longitudinal follow-up study using a national sample cohort.

Sci Rep 2019 09 16;9(1):13382. Epub 2019 Sep 16.

Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea.

This study aimed to investigate the occurrence of tonsillectomy in asthmatic children using a control group with a comparable frequency of a preoperative history of asthma. Asthmatic children ≤15 years old were collected from the Korean Health Insurance Review and Assessment Service - National Sample Cohort (HIRA-NSC) from 2002 through 2013. In study I, asthmatic children who had undergone a tonsillectomy (n = 2,326) and control I participants (n = 9,304) were selected and matched 1:4 for age, sex, income, and region of residence but not a preoperative history of asthma. Read More

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http://dx.doi.org/10.1038/s41598-019-49825-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746861PMC
September 2019
5 Reads

Safety of prolonged magnesium sulfate infusions during treatment for severe pediatric status asthmaticus.

Pediatr Pulmonol 2019 12 3;54(12):1941-1947. Epub 2019 Sep 3.

Pediatric Critical Care, University of Louisville, Louisville, Kentucky.

Objective: Magnesium sulfate (Mg) is one of several "second-tier" therapies for treating severe status asthmaticus. Pediatric reports primarily describe bolus use with limited data regarding prolonged infusions. We sought to describe the safety of prolonged Mg infusions during therapy of status asthmaticus in critically ill children. Read More

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http://dx.doi.org/10.1002/ppul.24499DOI Listing
December 2019
3 Reads

Population Pharmacokinetics of Intravenous Salbutamol in Children with Refractory Status Asthmaticus.

Clin Pharmacokinet 2020 Feb;59(2):257-264

Pediatric Intensive Care Unit, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.

Background: Intravenous salbutamol is used to treat children with refractory status asthmaticus, however insufficient pharmacokinetic data are available to guide initial and subsequent dosing recommendations for its intravenous use. The pharmacologic activity of salbutamol resides predominantly in the (R)-enantiomer, with little or no activity and even concerns of adverse reactions attributed to the (S)-enantiomer.

Objective: Our aim was to develop a population pharmacokinetic model to characterize the pharmacokinetic profile for intravenous salbutamol in children with status asthmaticus admitted to the pediatric intensive care unit (PICU), and to use this model to study the effect of different dosing schemes with and without a loading dose. Read More

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http://dx.doi.org/10.1007/s40262-019-00811-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7007440PMC
February 2020
2 Reads

Current Use of Neuromuscular Blocking Agents in Intensive Care Units.

Turk J Anaesthesiol Reanim 2019 Aug 24;47(4):273-281. Epub 2019 Jan 24.

Clinic of Anaesthesiology and Reanimation, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

Neuromuscular blocking agents can be used for purposes such as eliminating ventilator-patient dyssynchrony, facilitating gas exchange by reducing intra-abdominal pressure and improving chest wall compliance, reducing risk of lung barotrauma, decreasing contribution of muscles to oxygen consumption by preventing shivering and limiting elevations in intracranial pressure caused by airway stimulation in patients supported with mechanical ventilation in intensive care units. Adult Respiratory Distress Syndrome (ARDS), status asthmaticus, increased intracranial pressure and therapeutic hypothermia following ventricular fibrillation-associated cardiac arrest are some of clinical conditions that can be sustained by neuromuscular blockade. Appropriate indication and clinical practice have gained importance considering side effects such as ICU-acquired weakness, masking seizure activity and longer durations of hospital and ICU stays. Read More

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http://dx.doi.org/10.5152/TJAR.2019.33269DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6645848PMC
August 2019
7 Reads

Danger in the vapor? ECMO for adolescents with status asthmaticus after vaping.

J Asthma 2019 Jul 27:1-5. Epub 2019 Jul 27.

a Department of Pediatric Pulmonology, University of North Carolina School of Medicine , Chapel Hill , NC , USA.

Electronic nicotine delivery systems (ENDS) use is on the rise in the adolescent and young adult populations, especially in the wake of sweet flavored ENDS solutions and youth-targeted marketing. While the extent of effect of ENDS use and aerosolized flavorings on airway epithelium is not known, there remains significant concern that use of ENDS adversely affects airway epithelial function, particularly in populations with asthma. In this case series, we review two cases of adolescents with history of recent and past ENDS use and asthma who required veno-venous extracorporeal membrane oxygenation (VV-ECMO) for status asthmaticus in the year 2018. Read More

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http://dx.doi.org/10.1080/02770903.2019.1643361DOI Listing
July 2019
8 Reads

Medical Symbols: Part 5.

Authors:
Asha Pai-Dhungat

J Assoc Physicians India 2018 Oct;66(10):96

Professor and HOD Medicine (Retd.), T.N. Medical College & Nair Hospital, Mumbai, Maharashtra.

When a patient presents with wheezing, pulmonary embolism is not usually considered as a possible cause. However bronchoconstriction can be caused by the embolism which produces wheezing that may be so obvious to make a diagnosis of bronchial asthma. Here we present a case of sub-massive pulmonary embolism presenting predominantly with wheezing without any previous history of cardio pulmonary diseases. Read More

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October 2018
10 Reads

Pulmonary Embolism Mimicking Acute Severe Asthma.

J Assoc Physicians India 2018 Oct;66(10):11-12

Senior Resident -Internal Medicine, Olive Hospital, Hyderabad, Telangana.

When a patient presents with wheezing, pulmonary embolism is not usually considered as a possible cause. However bronchoconstriction can be caused by the embolism which produces wheezing that may be so obvious to make a diagnosis of bronchial asthma. Here we present a case of sub-massive pulmonary embolism presenting predominantly with wheezing without any previous history of cardio pulmonary diseases. Read More

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October 2018
6 Reads

Descriptions and outcomes of cardiac evaluations in pediatric patients hospitalized for asthma.

J Asthma 2019 Jul 22:1-7. Epub 2019 Jul 22.

b McGovern Medical School, University of Texas , Houston , TX , USA.

Patients hospitalized for asthma can exhibit concurrent cardiac symptoms and undergo cardiac work up. We identify patients admitted for asthma that underwent cardiac workup and describe outcomes to evaluate the utility of cardiac testing in this population. Patients aged 4 to 17 years admitted for status asthmaticus from 2012 - 2016 were screened for EKG, ECHO, or cardiac enzyme obtainment. Read More

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http://dx.doi.org/10.1080/02770903.2019.1642353DOI Listing
July 2019
5 Reads

Comparison of two continuous nebulized albuterol doses in critically ill children with status asthmaticus.

J Asthma 2019 Jun 12:1-7. Epub 2019 Jun 12.

a Department of Pediatrics, Section of Pediatric Critical Care , Nationwide Children's Hospital, The Ohio State University , Columbus , OH , USA.

: Continuous nebulized albuterol is frequently used to treat children with status asthmaticus in the pediatric intensive care unit (PICU) but can have cardiovascular side effects. Limited data exist comparing different dosages. The purpose of this study was to compare hemodynamic side effects of two continuous albuterol doses (10 vs. Read More

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http://dx.doi.org/10.1080/02770903.2019.1623249DOI Listing
June 2019
14 Reads

A Respiratory Therapist-Driven Asthma Pathway Reduced Hospital Length of Stay in the Pediatric Intensive Care Unit.

Respir Care 2019 Nov 14;64(11):1325-1332. Epub 2019 May 14.

Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina.

Background: Asthma is a common reason for admissions to the pediatric intensive care unit (PICU). Since June 2014, our institution has used a pediatric asthma clinical pathway for all patients, including those in PICU. The pathway promotes respiratory therapist-driven bronchodilator weaning based on the Modified Pulmonary Index Score (MPIS). Read More

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http://rc.rcjournal.com/lookup/doi/10.4187/respcare.06626
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http://dx.doi.org/10.4187/respcare.06626DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6945301PMC
November 2019
23 Reads

Successful Treatment of Refractory Status Asthmaticus Accompanied by Right Ventricular Dysfunction Using a Protek Duo Tandem Heart Device.

J Cardiothorac Vasc Anesth 2019 Nov 18;33(11):3085-3089. Epub 2019 Mar 18.

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI.

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http://dx.doi.org/10.1053/j.jvca.2019.03.031DOI Listing
November 2019
5 Reads

Stress ulcer prophylaxis in children with status asthmaticus receiving systemic corticosteroids: a descriptive study assessing frequency of clinically important bleeding.

J Asthma 2019 May 30:1-8. Epub 2019 May 30.

a Johns Hopkins All Children's Hospital , St. Petersburg , FL , USA.

To determine the frequency of clinically important bleeding (CIB) among children hospitalized for status asthmaticus with and without exposure to stress ulcer prophylaxis (SUP). We performed a single-center, retrospective cohort in 217 children admitted for asthma exacerbation aged 5-18 years from May 2015 to May 2017. We assessed cohorts with and without exposure to SUP to determine if differences in frequency of CIB exist. Read More

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http://dx.doi.org/10.1080/02770903.2019.1614617DOI Listing
May 2019
16 Reads

Synchronized abdominal compression as a novel treatment of life-threatening preschool asthma.

J Asthma 2020 Jul 24;57(7):765-768. Epub 2019 Apr 24.

Department of Paediatrics, Kwong Wah Hospital, Yau Ma Tei, Hong Kong, China.

In severe asthma, management of life-threatening air trapping that persists despite initiation of standard asthma treatment is difficult in the absence of extracorporeal membranous oxygenation. Three children with life-threatening asthma could not be adequately ventilated despite maximum conventional treatment because of severe air trapping. A novel method of active expiration by abdominal compression with a standard ventilator was adopted with immediate effect with significant improvement in ventilation. Read More

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https://www.tandfonline.com/doi/full/10.1080/02770903.2019.1
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http://dx.doi.org/10.1080/02770903.2019.1606234DOI Listing
July 2020
20 Reads

Novel pediatric-automated respiratory score using physiologic data and machine learning in asthma.

Pediatr Pulmonol 2019 08 21;54(8):1149-1155. Epub 2019 Apr 21.

Department of Pediatrics, Colorado School of Medicine, The Breathing Institute, University of Colorado, Children's Hospital Colorado, Aurora, Colorado.

Objectives: Manual clinical scoring systems are the current standard used for acute asthma clinical care pathways. No automated system exists that assesses disease severity, time course, and treatment impact in pediatric acute severe asthma exacerbations.

Working Hypothesis: machine learning applied to continuous vital sign data could provide a novel pediatric-automated asthma respiratory score (pARS) by using the manual pediatric asthma score (PAS) as the clinical care standard. Read More

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http://dx.doi.org/10.1002/ppul.24342DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6641986PMC
August 2019
5 Reads

Pharmacokinetics of Ketamine at Dissociative Doses in an Adult Patient With Refractory Status Asthmaticus Receiving Extracorporeal Membrane Oxygenation Therapy.

Clin Ther 2019 05 28;41(5):994-999. Epub 2019 Mar 28.

Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Purpose: First-line management of severe asthma exacerbations include the use of inhaled short-acting β-agonists, anticholinergics, and systemic corticosteroids. Continuous intravenous ketamine given at dissociative doses may be a pharmacologic option in patients who are intubated with life-threatening severe bronchospasm unresponsive to standard therapy. We describe the case of a 44-year-old man admitted to the intensive care unit for status asthmaticus requiring intubation and mechanical ventilation. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S01492918193011
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http://dx.doi.org/10.1016/j.clinthera.2019.03.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7197266PMC
May 2019
20 Reads

Implementing a Respiratory Therapist-Driven Continuous Albuterol Weaning Protocol in the Pediatric ICU.

Respir Care 2019 Nov 19;64(11):1358-1365. Epub 2019 Mar 19.

Department of Pediatrics, Division of Critical Care Medicine, Indiana University School of Medicine/Riley Hospital for Children at IU Health, Indianapolis, IN.

Background: Status asthmaticus is one of the most frequent admission diagnoses in the pediatric ICU (PICU). Collaboration between respiratory therapists (RTs) and physicians may help efficiently deliver care to a patient in status asthmaticus. The Pediatric Asthma Severity Score (PASS) is a measure of severity of a patient's asthma exacerbation at a point in time. Read More

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http://rc.rcjournal.com/lookup/doi/10.4187/respcare.06447
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http://dx.doi.org/10.4187/respcare.06447DOI Listing
November 2019
26 Reads

Status asthmaticus requiring extracorporeal membrane oxygenation associated with rhinovirus infection.

J Asthma 2020 Mar 18;57(3):343-346. Epub 2019 Mar 18.

Division of Pulmonology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA.

: Evolving research links human rhinovirus (HRV) with status asthmaticus (SA) as well as severe respiratory illness in patients with atopy and asthma. This case series reviews five episodes of HRV-associated SA that required extracorporeal membrane oxygenation (ECMO). : Charts of four patients, five total episodes of ECMO, with SA secondary to HRV were reviewed in this IRB-approved case series. Read More

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http://dx.doi.org/10.1080/02770903.2019.1565826DOI Listing
March 2020
9 Reads

Asthma deaths in North Carolina: 1999-2016.

J Asthma 2020 May 27;57(5):478-486. Epub 2019 Feb 27.

Department of Biostatistics, Brody School of Medicine, East Carolina University, Greenville, NC, USA.

Despite the significant decline in overall death rates in the U.S. over the past decade, many asthma deaths could have been avoided. Read More

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http://dx.doi.org/10.1080/02770903.2019.1579830DOI Listing
May 2020
7 Reads

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
Publisher Site
http://dx.doi.org/10.12890/2018_000823DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346923PMC
May 2018
40 Reads