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Acta Pediátrica Costarricense

Print version ISSN 1409-0090


RODRIGUEZ-HERRERA, Gilberto; SOLIS-MOYA, Arturo  and  GUTIERREZ-SCHWANHAUSER, José Pablo. Severe asthmatic crisis in children aged 6 through 13 years: analysis and follow up after discharge from the intensive care unit. Acta pediátr. costarric [online]. 2009, vol.21, n.1, pp.33-40. ISSN 1409-0090.

Aim: Costa Rica is one of the countries with a highest prevalence of asthma in children and adolescents worldwide. The purpose of this study was to describe all the children aged 6 to 13 years, admitted to a ICU between January 2000 to December 2006 because of a acute severe asthmatic crisis. Methods: We review the medical charts of all the patients and interviewed a random sample of 20 parents. Parents were asked about the child’s condition after he was delivered of the hospital, their asthma management practices, the severity of the symptoms and the present medications. Also, their children receive spirometry testing. Results: A total of 75 patients were included in the analysis; 33 were boys and 42 girls. The main decision to admit the children to the ICU was to commence an IV infusion of salbutamol (75.6%). Other pharmacologic agents used included nebulized B2 agonists (100%), nebulized ipratropium bromide (100%), IV steroids (93%) , IV aminophylline (56%), magnesium sulfate (28%) and antibiotics (40%). Mechanical ventilation was necessary in 18.6% of admissions. The average stay for our patient group in ICU was 3.28 days. After the hospitalization, there was at least 10 patients of the random sample without follow-up and 11 receiving no preventive-treatment. Conclusions: There has been a decrease in the number of hospital admissions for asthma in the past 6 years. Actually, it has been demonstrated that salbutamol IV is safely and effective in treating infants with acute severe exacerbations of asthma not necessarily in a ICU. Families often do not have written asthma action plans. Effective outpatient care is believed to prevent hospitalization and emergency department visits resulting from childhood asthma.

Keywords : severe asthmatic crisis; intensive care; children.

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