Evaluation of Patients with Severe Asthma Exacerbation treated in a Pediatric Intensive Care Unit: 8 Years of Single-Center Experience

Abstract

Aim: In this study, we aimed to evaluate the demographic and clinical characteristics of pediatric patients followed in tertiary pediatric intensive care unit (PICU) due to severe asthma exacerbation (SAE) and to discuss the optimal intensive care management for these patients. Material and Method: We retrospectively analyzed a total of 103 patients between the ages of 12 months and 18 years who were followed up in the PICU with a diagnosis of SAE between 2013 and 2020. Results: On the evaluation of data in terms of respiratory support, it was observed that 34 (33%) of the patients were treated during follow-up with, nasal oxygen cannula or standard non-rebreather oxygen face mask (NC/NRB), 13 (12.6%) with high-flow nasal cannula oxygenation (HFNC), 46 (44.7%) with non-invasive mechanical ventilation (NIMV), and 10 (9.7%) with invasive mechanical ventilation (IMV). When the respiratory supports applied by years were evaluated, the rate of invasive mechanical ventilation usage decreased significantly in recent years compared to the first years (5.6% and 20%; respectively; p < 0.001). Pneumothorax developed in one (1%) patient. No patient died among 103 patients who were followed up. Conclusion: We think that early initiation of HFNC or NIMV in combination with bronchodilators, systemic corticosteroids, and if necessary, intravenous magnesium sulfate is a safe and viable treatment option for SAE treatment. In SAE cases in the PICU, the pediatric intensive care specialist should systematically evaluate the patient and quickly decide whether there is a need for respiratory support and additional treatment.

Keywords

• severe asthma exacerbation
• pediatric intensive care
• non-invasive mechanical ventilation
• şiddetli astım atağı
• çocuk yoğun bakım
• non-invaziv mekanik ventilasyon