Treatment patterns and frequency of key outcomes in acute severe asthma in children: A Paediatric Research in Emergency Departments International Collaborative (PREDICT) multicentre cohort study

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dc.contributor.authorCraig, S.
dc.contributor.authorPowell, C.V.E.
dc.contributor.authorNixon, G.M.
dc.contributor.authorOakley, E.
dc.contributor.authorHort, J.
dc.contributor.authorArmstrong, D.S.
dc.contributor.authorRanganathan, S.
dc.contributor.authorKochar, A.
dc.contributor.authorWilson, C.
dc.contributor.authorGeorge, S.
dc.contributor.authorPhillips, N.
dc.contributor.authorFuryk, J.
dc.contributor.authorLawton, B.
dc.contributor.authorBorland, M.L.
dc.contributor.authorO'Brien, S.
dc.contributor.authorNeutze, J.
dc.contributor.authorLithgow, A.
dc.contributor.authorMitchell, C.
dc.contributor.authorWatkins, N.
dc.contributor.authorBrannigan, D.
dc.contributor.authoret al.
dc.date.issued2022
dc.description.abstractRationale: Severe acute paediatric asthma may require treatment escalation beyond systemic corticosteroids, inhaled bronchodilators and lowflow oxygen. Current large asthma datasets report parenteral therapy only. Objectives To identify the use and type of escalation of treatment in children presenting to hospital with acute severe asthma. Methods: Retrospective cohort study of children with an emergency department diagnosis of asthma or wheeze at 18 Australian and New Zealand hospitals. The main outcomes were use and type of escalation treatment (defined as any of intensive care unit admission, nebulised magnesium, respiratory support or parenteral bronchodilator treatment) and hospital length of stay (LOS). Measurements and main results: Of 14 029 children (median age 3 (IQR 1–3) years; 62.9% male), 1020 (7.3%, 95% CI 6.9% to 7.7%) had treatment escalation. Children with treatment escalation had a longer LOS (44.2 hours, IQR 27.3–63.2 hours) than children without escalation 6.7 hours, IQR 3.5–16.3 hours; p<0.001). The most common treatment escalations were respiratory support alone (400; 2.9%, 95% CI 2.6% to 3.1%), parenteral bronchodilator treatment alone (380; 2.7%, 95% CI 2.5% to 3.0%) and both respiratory support and parenteral bronchodilator treatment (209; 1.5%, 95% CI 1.3% to 1.7%). Respiratory support was predominantly nasal high-flow therapy (99.0%). The most common intravenous medication regimens were: magnesium alone (50.4%), magnesium and aminophylline (24.6%) and magnesium and salbutamol (10.0%).
dc.description.statementofresponsibilitySimon Craig ... Charmaine Gray ... Amit Kochar ... et. al
dc.identifier.citationBMJ Open Respiratory Research, 2022; 9(1):e001137-1-e001137-9
dc.identifier.doi10.1136/bmjresp-2021-001137
dc.identifier.issn2052-4439
dc.identifier.issn2052-4439
dc.identifier.orcidGray, C. [0000-0002-3625-6505]
dc.identifier.urihttps://hdl.handle.net/2440/135001
dc.language.isoen
dc.publisherBMJ Publishing Group
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/GNT1058560
dc.rights© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
dc.source.urihttps://doi.org/10.1136/bmjresp-2021-001137
dc.subjectAsthma
dc.subject.meshHumans
dc.subject.meshAsthma
dc.subject.meshRetrospective Studies
dc.subject.meshCohort Studies
dc.subject.meshChild
dc.subject.meshChild, Preschool
dc.subject.meshInfant
dc.subject.meshEmergency Service, Hospital
dc.subject.meshAustralia
dc.subject.meshFemale
dc.subject.meshMale
dc.titleTreatment patterns and frequency of key outcomes in acute severe asthma in children: A Paediatric Research in Emergency Departments International Collaborative (PREDICT) multicentre cohort study
dc.typeJournal article
pubs.publication-statusPublished

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