Faculty of Medicine, McGill University, Montreal, Canada.
Division of Respiratory Medicine, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Canada.
Pediatr Allergy Immunol Pulmonol. 2021 Mar;34(1):1-6. doi: 10.1089/ped.2020.1271.
To determine the lung function of children admitted to the intensive care unit (ICU) for a severe asthma exacerbation in the medium- to long-term following hospital discharge. We performed a retrospective chart review of children ≥6 years of age admitted to the ICU for a severe asthma exacerbation at a tertiary care center from January 1, 2000, to December 31, 2013. Lung function was ascertained during outpatient follow-up visits at 3-12 months and 12-24 months postdischarge. A total of 72 subjects met the inclusion criteria. Subjects were predominantly boys (56.9%) and had a mean (standard deviation [SD]) age at admission of 10.3 years (3.4 years). The median (interquartile range) length of stay in the ICU was 1 day (1-3 days). Thirty-eight and 28 subjects performed pulmonary function tests with acceptable technique at the 3-12 months and 12-24 months postdischarge visits, respectively. At 3-12 months, the mean (SD) predicted forced expiratory volume in 1 s (FEV) and forced expiratory flow between 25% and 75% of vital capacity (FEF) percent were 95.9 (16.7) and 76.7 (25.8), respectively, and 97.4 (17.6) and 70.5 (24.9), respectively, at 12-24 months. FEV/forced vital capacity (FEV/FVC) was 81.7 (8.3) at 3-12 months and 79.3 (7.7) at 12-24 months. A paired -test on 20 subjects who performed acceptable spirometry at both visits showed a significant intraindividual decrease in FEV ( = 0.008), FEF ( = 0.02), and FEV/FVC ( = 0.01) between the 2 time points. Although prospective studies are required to confirm our findings, our study suggests that children admitted to the ICU for severe asthma exacerbations may be at risk for declining pulmonary function in the medium- to long-term postdischarge.
确定因严重哮喘发作而入住重症监护病房(ICU)的儿童在出院后中-长期的肺功能。
我们对 2000 年 1 月 1 日至 2013 年 12 月 31 日期间在一家三级保健中心因严重哮喘发作而入住 ICU 的年龄≥6 岁的儿童进行了回顾性图表审查。出院后 3-12 个月和 12-24 个月的门诊随访时确定肺功能。共有 72 名受试者符合纳入标准。受试者主要为男孩(56.9%),入院时的平均(标准差[SD])年龄为 10.3 岁(3.4 岁)。ICU 中位(四分位间距)住院时间为 1 天(1-3 天)。分别有 38 名和 28 名受试者在出院后 3-12 个月和 12-24 个月的随访时进行了可接受技术的肺功能检查。在 3-12 个月时,平均(SD)预测的 1 秒用力呼气量(FEV)和用力肺活量 25%-75%之间的流量(FEF)%分别为 95.9(16.7)和 76.7(25.8),分别为 97.4(17.6)和 70.5(24.9)。FEV/用力肺活量(FEV/FVC)在 3-12 个月时为 81.7(8.3),在 12-24 个月时为 79.3(7.7)。在 20 名在两次就诊时均进行了可接受的肺活量测定的受试者中进行配对检验,发现两次就诊之间 FEV( = 0.008)、FEF( = 0.02)和 FEV/FVC( = 0.01)的个体内显著降低。
尽管需要前瞻性研究来证实我们的发现,但我们的研究表明,因严重哮喘发作而入住 ICU 的儿童在出院后的中-长期可能存在肺功能下降的风险。