Clinical Course of Children with Status Asthmaticus Admitted in an Albanian PICU

Background: Many countries have reported an overall increase in PICU admissions for status asthmaticus (SA). There are varieties of approach to treatment of SA. Aggressive medical therapy should be promptly instituted to avoid respiratory failure and mechanical ventilation.

Objective: The aim of our study was to analyze the clinical course of children with SA treated in our PICU.

Methods: This is a retrospective study. Inclusion criteria were children 2-14 years of age, hospitalized at our PICU during the period 2015-2020, with the diagnosis of SA. Data included were: age, vital signs, medical history, blood gas analyses, medications used before admissions, length of PICU stay, respiratory support. To evaluate the severity of SA we used Pediatric asthma score (PASS). Subjects were put into one of three categories based on PASS: ≤7 points (mild); 8-11points (moderate) and ≥12 points (severe).

Results: During the study period 28 children were admitted in our PICU. We haven’t noticed any increase in the number of admissions per year over time. The severity of SA seemed unchanged based on blood gas analyses, PASS, need for second line therapy, support of respiratory failure and length of stay. Based on PASS, 32.1% of cases were severe, 64.3% moderate and 3.6% mild. The age distribution across all groups was similar. All patients received parenteral steroid and Salbutamol aerosol. In 82% of cases it was necessary the use of Aminophylline and in 28.5% MgSO4 intravenous. Only 89% of cases needed Oxygen therapy, but no one noninvasive or invasive ventilation.

Conclusion: In opposite with other countries, we haven’t noticed changes in PICU admissions for SA. The severity seemed unchanged. With aggressive therapy we have avoided respiratory failure and mechanical ventilation in all cases. A higher PASS was associated with a longer time of O2 support and a longer stay in the PICU.