Rampersad Neeta, Wilkins Barry, Egan Jonathan R
Paediatric Intensive Care Unit, Children's Hospital at Westmead, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2018 Jun;54(6):633-637. doi: 10.1111/jpc.13855. Epub 2018 Feb 22.
The aim of this study was to characterise patients with asthma admitted to an Australian paediatric intensive care unit (PICU).
This was a retrospective review of patients with asthma admitted to a university-affiliated, 23-bed, tertiary PICU between January 2000 and December 2011, with a subset of pharmacotherapy and biochemical data from patients admitted between July 2007 and December 2011.
A total of 589 admissions (501 patients) with asthma over 12 years constituted 4.4% of all PICU admissions. Three patients died (0.6%). Non-invasive ventilation (NIV) was used in 104 (17.7%) admissions, and 41 (7%) were invasively ventilated. On 12 (2%) occasions, patients received both NIV and invasive ventilation. Over 12 years, there was a significant trend to increased use of NIV, 11-39% (P < 0.0001), and invasive ventilation, 6-14% (P < 0.001). All received steroids and nebulised β2-agonists. A total of 92% received intravenous (IV) β2-agonists, 65% of these for less than 12 h. PICU and hospital stay were proportional to the duration of IV β2-agonist infusion (P < 0.0001). A total of 47.1% received IV magnesium sulphate, increasing from 19 to 75% (P < 0.001). The majority (48%) were transferred directly to PICU from other hospitals. Median PICU stay was 1.04 days (0.72-1.63); hospital stay was 3.16 days (2.29-4.71), and both were unchanged.
Intensive care length of stay (LOS) was unchanged over 12 years. Both invasive and NIV and IV magnesium sulphate use increased. LOS was directly related to the duration of IV β2-agonist. Asthma patients admitted to PICU typically have a brief stay and have a fairly predictable course. Prospective studies could explore the contribution of IV agents and the role of NIV.
本研究旨在对入住澳大利亚儿科重症监护病房（PICU）的哮喘患者进行特征描述。
这是一项对2000年1月至2011年12月期间入住一所大学附属的、拥有23张床位的三级PICU的哮喘患者的回顾性研究，其中一部分患者的药物治疗和生化数据来自2007年7月至2011年12月期间入院的患者。
12年间共有589例哮喘患者入院（501名患者），占PICU所有入院患者的4.4%。3例患者死亡（0.6%）。104例（17.7%）入院患者使用了无创通气（NIV），41例（7%）接受了有创通气。有12次（2%）患者同时接受了NIV和有创通气。在12年期间，NIV的使用有显著增加趋势，从11%增至39%（P<0.0001），有创通气的使用也有增加趋势，从6%增至14%（P<0.001）。所有患者均接受了类固醇和雾化β2激动剂治疗。共有92%的患者接受了静脉注射（IV）β2激动剂，其中65%的患者使用时间少于12小时。PICU住院时间和住院总时间与IVβ2激动剂输注时间成正比（P<0.0001）。共有47.1%的患者接受了静脉注射硫酸镁，比例从19%增至75%（P<0.001）。大多数患者（48%）是从其他医院直接转入PICU的。PICU中位住院时间为1.04天（0.72 - 1.63天）；住院总时间为3.16天（2.29 - 4.71天），且两者均无变化。
12年间重症监护住院时间（LOS）无变化。有创通气、NIV和静脉注射硫酸镁的使用均有所增加。LOS与IVβ2激动剂的使用时间直接相关。入住PICU的哮喘患者通常住院时间较短，病程较可预测。前瞻性研究可探讨静脉注射药物的作用及NIV的作用。
