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本文引用的文献

1
Time to Asthma-Related Readmission in Children Admitted to the ICU for Asthma.儿童因哮喘入住 ICU 后哮喘相关再入院时间。
Pediatr Crit Care Med. 2017 Dec;18(12):1099-1105. doi: 10.1097/PCC.0000000000001336.
2
Childhood Lung Function Predicts Adult Chronic Obstructive Pulmonary Disease and Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome.儿童肺功能可预测成人慢性阻塞性肺疾病和哮喘-慢性阻塞性肺疾病重叠综合征。
Am J Respir Crit Care Med. 2017 Jul 1;196(1):39-46. doi: 10.1164/rccm.201606-1272OC.
3
Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma.持续性儿童哮喘肺功能的生长与衰退模式
N Engl J Med. 2016 May 12;374(19):1842-1852. doi: 10.1056/NEJMoa1513737.
4
Medical and Social Determinants of Health Associated with Intensive Care Admission for Asthma in Children.与儿童哮喘重症监护入院相关的健康的医学和社会决定因素。
Ann Am Thorac Soc. 2016 Jul;13(7):1081-8. doi: 10.1513/AnnalsATS.201512-798OC.
5
Clinical Implications of Having Reduced Mid Forced Expiratory Flow Rates (FEF25-75), Independently of FEV1, in Adult Patients with Asthma.成年哮喘患者中,独立于第一秒用力呼气容积(FEV1)之外的用力呼气中期流速(FEF25-75)降低的临床意义
PLoS One. 2015 Dec 30;10(12):e0145476. doi: 10.1371/journal.pone.0145476. eCollection 2015.
6
Underuse of guideline-recommended long-term asthma management in children hospitalized to the intensive care unit: a multicenter observational study.儿童重症监护病房住院患儿指南推荐的长期哮喘管理不足:一项多中心观察性研究。
Ann Allergy Asthma Immunol. 2015 Jul;115(1):10-6.e1. doi: 10.1016/j.anai.2015.05.004.
7
Progression of Irreversible Airflow Limitation in Asthma: Correlation with Severe Exacerbations.哮喘不可逆气流受限的进展:与严重加重的相关性。
J Allergy Clin Immunol Pract. 2015 Sep-Oct;3(5):759-64.e1. doi: 10.1016/j.jaip.2015.05.005. Epub 2015 Jun 6.
8
Asthma, airflow limitation and mortality risk in the general population.普通人群中的哮喘、气流受限与死亡风险
Eur Respir J. 2015 Feb;45(2):338-46. doi: 10.1183/09031936.00108514. Epub 2014 Oct 16.
9
Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.儿科复杂慢性病分类系统第2版:针对国际疾病分类第十版(ICD - 10)以及复杂医疗技术依赖和移植进行了更新。
BMC Pediatr. 2014 Aug 8;14:199. doi: 10.1186/1471-2431-14-199.
10
Changes in forced expiratory volume in 1 second over time in patients with controlled asthma at baseline.基线时病情得到控制的哮喘患者1秒用力呼气容积随时间的变化
Respir Med. 2014 Jul;108(7):976-82. doi: 10.1016/j.rmed.2014.04.014. Epub 2014 May 10.

哮喘患儿入住重症监护病房后的肺功能。

Lung Function of Children Following an Intensive Care Unit Admission for Asthma.

机构信息

Faculty of Medicine, McGill University, Montreal, Canada.

Division of Respiratory Medicine, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Canada.

出版信息

Pediatr Allergy Immunol Pulmonol. 2021 Mar;34(1):1-6. doi: 10.1089/ped.2020.1271.

DOI:10.1089/ped.2020.1271
PMID:33734876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8082037/
Abstract

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.

摘要

目的

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。

方法

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。

结论

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。