Abstract
Introduction: Asthma is a common chronic childhood respiratory disorder characterized by episodes of acute shortness of breath, cough, and wheezing that are due to chronic airway inflammation. The present study aimed to investigate the predictors of Pediatric Intensive Care Unit (PICU) admission among 2-12 years old children with exacerbated asthma.
Materials and Methods: This retrospective chart review study was approved by the institutional review board at Abha Maternity and Children Hospital, Saudi Arabia. Children were also enrolled if the parents reported previous use of inhaled corticosteroids for asthma control therapy. The diagnosis of asthma was confirmed by either a pediatric allergist or a pulmonologist who was actively involved in inpatient and outpatient asthma care.
Results: Of the 128 patients enrolled in the study, 31 required PICU admissions. No statistically significant difference was detected between age and age categories (<3, 3-6, and >6 years) in children admitted to the pediatric ward and PICU. Children who had previous PICU admissions, one, two, and three times have high odds of being admitted to the PICU during the current asthma exacerbation. These odds did not change after adjusting for the gender, prevalence of food allergy, previous inhaled corticosteroid (ICS) use, and age. Independent of age, gender, and previous use of ICS, previous PICU admissions and emergency department (ED) triage peripheral capillary oxygen saturation (SpO2) are statistically significant factors to predict the current PICU admissions required for children with acute asthma exacerbations between 2 and 12 years of age.
Conclusion: Previous PICU admissions and SpO2 measurements at the emergency department (ED) are independent predictors of needing intensive care admission for children between 2 and 12 years of age with acute asthma exacerbation. Nevertheless, further studies are needed to explore additional modifiable predictors that could help in identifying children with a high risk for intensive care admissions.