Background: Patients with asthma admitted to the pediatric Intensive Care Unit (ICU) are often found to have had previous severe asthma exacerbations.
Objective: To evaluate the outcome of children following pediatric ICU admission prospectively.
Methods: Patients, aged 2-18 years, admitted to the pediatric ICU at Assaf Harofeh Medical Center over a 10-year period were assessed at a mean of 10 years after their admission and compared to matched patients admitted to the pediatric ward. Each patient filled a questionnaire on subsequent hospitalizations and current asthma treatment and control. Pulmonary function studies and allergy skin tests were performed.
Results: Compared to patients admitted to the pediatric ward, those admitted to the pediatric ICU had more hospitalization and ICU admissions following their index admission (p=0.022 and p=0.021, respectively). Most (60-70%) patients in both groups had uncontrolled asthma and 47% of those (ICU) and 33% (ward) were not receiving controller therapy. Patients in the pediatric ICU group had more recent asthma exacerbations (p=0.014), and weekly wheezing (p=0.017) and bronchodilator use (p=0.007). Lung function tests were comparable between the 2 groups but 30 45% in each group had airflow obstruction. No significant differences were found between pre-school and school-aged children in any of the parameters.
Conclusions: Compared to patients admitted to the pediatric ward, those admitted to the ICU with asthma exacerbations, experience more asthma-related hospitalizations and their asthma less controlled even years later. The lack of regular follow-up and controller therapy in most patients following asthma hospitalization suggest that this increased morbidity might be prevented.
