Carroll Christopher L, Schramm Craig M, Zucker Aaron R
Department of Pediatrics, Division of Pediatric CriticalCare, Connecticut Children's Medical Center, Hartford, Connecticut 06106, USA.
J Asthma. 2008 Aug;45(6):513-7. doi: 10.1080/02770900802017751.
NHLBI guidelines classify asthma in children as intermittent, mild persistent, moderate persistent, and severe persistent asthma based on baseline symptoms and pulmonary function. However, this may not capture the spectrum of asthma in children, since even mild baseline disease can have significant effects on quality of life. Our objective was to describe a population of children with mild asthma admitted to the ICU with severe exacerbations.
We examined data from all children with asthma who were admitted to the ICU with an acute exacerbation between April 1997, and December 2006. Children were defined as having mild asthma if their disease was classified as intermittent or mild persistent according to NHLBI criteria.
Of the 298 children admitted to the ICU with asthma, 164 (55%) were classified as having mild baseline asthma. Compared with children with more severe baseline asthma, mild asthmatic children were younger and less likely to have been previously admitted to the hospital for asthma. Other demographics, including admission severity of illness, gender, and prevalence of overweight, were similar in the two groups. There were no differences between the groups in ICU length of stay, hospital length of stay or types of therapies received. Thirteen children with mild asthma were intubated, although less frequently than those with more severe disease.
Children with mild asthma have severe exacerbations. This suggests that chronic asthma severity does not necessarily predict asthma phenotypes during acute exacerbations.
美国国立心肺血液研究所（NHLBI）的指南根据基线症状和肺功能将儿童哮喘分为间歇性、轻度持续性、中度持续性和重度持续性哮喘。然而，这可能无法涵盖儿童哮喘的全部范围，因为即使是轻度的基线疾病也可能对生活质量产生重大影响。我们的目的是描述一组因严重急性加重而入住重症监护病房（ICU）的轻度哮喘儿童。
我们检查了1997年4月至2006年12月期间因急性加重而入住ICU的所有哮喘儿童的数据。根据NHLBI标准，如果儿童的疾病被分类为间歇性或轻度持续性，则定义为患有轻度哮喘。
在298名因哮喘入住ICU的儿童中，164名（55%）被分类为具有轻度基线哮喘。与基线哮喘更严重的儿童相比，轻度哮喘儿童更年轻，以前因哮喘住院的可能性更小。两组的其他人口统计学特征，包括入院时的疾病严重程度、性别和超重患病率相似。两组在ICU住院时间、住院时间或接受的治疗类型方面没有差异。13名轻度哮喘儿童接受了插管治疗，尽管频率低于病情更严重的儿童。
轻度哮喘儿童会出现严重急性加重。这表明慢性哮喘的严重程度不一定能预测急性加重期间的哮喘表型。
