Severe exacerbations in children with mild asthma: Characterizing a pediatric phenotype
Severe exacerbations in children with mild asthma: Characterizing a pediatric phenotype
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DOI：
10.1080/02770900802017751
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发表时间：
2008-01-01
影响因子：
1.9
通讯作者：
Zucker, Aaron R.
中科院分区：
文献类型：
--
作者：
Carroll, Christopher L.;Schramm, Craig M.;Zucker, Aaron R.
背景：NHLBI指南根据基线症状和肺功能将儿童哮喘分为间歇性哮喘、轻度持续性哮喘、中度持续性哮喘和重度持续性哮喘。然而，这可能不能涵盖儿童哮喘的范围，因为即使是轻微的基线疾病也可能对生活质量产生重大影响。我们的目标是描述一组住进重症监护室的轻度哮喘儿童。方法：我们检查了1997年4月至2006年12月间所有因急性加重而住进ICU的哮喘儿童的资料。根据NHLBI标准，如果儿童的疾病被归类为间歇性或轻度持续性，则定义为轻度哮喘。结果：在入住ICU的298名哮喘儿童中，164名(55%)被归类为轻度基线哮喘。与基线哮喘较严重的儿童相比，轻度哮喘儿童年龄更小，以前因哮喘入院的可能性也更小。其他人口统计学数据，包括入院疾病严重程度、性别和超重流行率，在两组中都是相似的。在ICU住院时间、住院时间或接受治疗类型方面，两组之间没有差异。13名患有轻度哮喘的儿童接受了气管插管，尽管频率低于那些病情较严重的儿童。结论：轻度哮喘患儿病情加重。这表明慢性哮喘的严重程度并不一定能预测急性加重期的哮喘表型。
Background: 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. Methods: 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. Results: 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. Conclusions: Children with mild asthma have severe exacerbations. This suggests that chronic asthma severity does not necessarily predict asthma phenotypes during acute exacerbations.