Maya Antionette Root, Carolyn Maria Ibrahim Pavlich, Anthony Alexander Sochet, Alexa Rae Roberts, Brett Walter Russi
{"title":"小儿重症哮喘患者在持续服用阿布特罗期间的口服营养:匹配队列研究","authors":"Maya Antionette Root, Carolyn Maria Ibrahim Pavlich, Anthony Alexander Sochet, Alexa Rae Roberts, Brett Walter Russi","doi":"10.5223/pghn.2024.27.6.364","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The practice of withholding oral nutrition for children hospitalized for critical asthma receiving continuous albuterol is not evidence based. We sought to characterize oral nutrition practices in this population and estimate the frequency of aspiration-related respiratory failure.</p><p><strong>Methods: </strong>We performed a single-center retrospective, matched cohort study of children 3-17 years of age admitted to a pediatric intensive care unit from Oct 2020 to May 2023 for critical asthma receiving continuous albuterol. Cases provided oral nutrition were matched 1:2 to controls withheld nutrition by age and National Heart Lung and Blood Institute asthma severity classification. The primary outcome was aspiration-related respiratory failure defined as any respiratory support escalation following observed aspiration. Descriptive data included demographics, anthropometrics, pediatric asthma severity scores, adjunct asthma interventions, continuous albuterol duration, mortality, and length of stay.</p><p><strong>Results: </strong>Of 36 cases and 72 matched controls, the mean age was 9.1±3.9 years and 66.7% had moderate-severe persistent asthma. Cases and controls had comparable anthropometrics and admission pediatric asthma severity scores. No aspiration-related respiratory failure events were observed even among those receiving nutrition concurrent to noninvasive ventilation. Compared to controls, cases experienced a longer continuous albuterol duration (median: 1.1 [interquartile range: 0.7-1.8] versus 0.7 [interquartile range: 0.3-1.3] days, <i>p</i><0.001). No differences in length of stay, adjunct interventions, endotracheal intubation rates, and mortality were observed between cases and controls.</p><p><strong>Conclusion: </strong>For children hospitalized for critical asthma, oral nutrition during continuous nebulized albuterol appeared well tolerated. While prospective validation is required, the practice of withholding oral nutrition for continuous albuterol administration may be unwarranted.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"27 6","pages":"364-371"},"PeriodicalIF":1.3000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570357/pdf/","citationCount":"0","resultStr":"{\"title\":\"Oral Nutrition During Continuous Albuterol for Pediatric Critical Asthma: A Matched Cohort Study.\",\"authors\":\"Maya Antionette Root, Carolyn Maria Ibrahim Pavlich, Anthony Alexander Sochet, Alexa Rae Roberts, Brett Walter Russi\",\"doi\":\"10.5223/pghn.2024.27.6.364\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The practice of withholding oral nutrition for children hospitalized for critical asthma receiving continuous albuterol is not evidence based. We sought to characterize oral nutrition practices in this population and estimate the frequency of aspiration-related respiratory failure.</p><p><strong>Methods: </strong>We performed a single-center retrospective, matched cohort study of children 3-17 years of age admitted to a pediatric intensive care unit from Oct 2020 to May 2023 for critical asthma receiving continuous albuterol. Cases provided oral nutrition were matched 1:2 to controls withheld nutrition by age and National Heart Lung and Blood Institute asthma severity classification. The primary outcome was aspiration-related respiratory failure defined as any respiratory support escalation following observed aspiration. Descriptive data included demographics, anthropometrics, pediatric asthma severity scores, adjunct asthma interventions, continuous albuterol duration, mortality, and length of stay.</p><p><strong>Results: </strong>Of 36 cases and 72 matched controls, the mean age was 9.1±3.9 years and 66.7% had moderate-severe persistent asthma. Cases and controls had comparable anthropometrics and admission pediatric asthma severity scores. No aspiration-related respiratory failure events were observed even among those receiving nutrition concurrent to noninvasive ventilation. Compared to controls, cases experienced a longer continuous albuterol duration (median: 1.1 [interquartile range: 0.7-1.8] versus 0.7 [interquartile range: 0.3-1.3] days, <i>p</i><0.001). No differences in length of stay, adjunct interventions, endotracheal intubation rates, and mortality were observed between cases and controls.</p><p><strong>Conclusion: </strong>For children hospitalized for critical asthma, oral nutrition during continuous nebulized albuterol appeared well tolerated. While prospective validation is required, the practice of withholding oral nutrition for continuous albuterol administration may be unwarranted.</p>\",\"PeriodicalId\":19989,\"journal\":{\"name\":\"Pediatric Gastroenterology, Hepatology & Nutrition\",\"volume\":\"27 6\",\"pages\":\"364-371\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570357/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Gastroenterology, Hepatology & Nutrition\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5223/pghn.2024.27.6.364\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Gastroenterology, Hepatology & Nutrition","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5223/pghn.2024.27.6.364","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/5 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PEDIATRICS","Score":null,"Total":0}
Oral Nutrition During Continuous Albuterol for Pediatric Critical Asthma: A Matched Cohort Study.
Purpose: The practice of withholding oral nutrition for children hospitalized for critical asthma receiving continuous albuterol is not evidence based. We sought to characterize oral nutrition practices in this population and estimate the frequency of aspiration-related respiratory failure.
Methods: We performed a single-center retrospective, matched cohort study of children 3-17 years of age admitted to a pediatric intensive care unit from Oct 2020 to May 2023 for critical asthma receiving continuous albuterol. Cases provided oral nutrition were matched 1:2 to controls withheld nutrition by age and National Heart Lung and Blood Institute asthma severity classification. The primary outcome was aspiration-related respiratory failure defined as any respiratory support escalation following observed aspiration. Descriptive data included demographics, anthropometrics, pediatric asthma severity scores, adjunct asthma interventions, continuous albuterol duration, mortality, and length of stay.
Results: Of 36 cases and 72 matched controls, the mean age was 9.1±3.9 years and 66.7% had moderate-severe persistent asthma. Cases and controls had comparable anthropometrics and admission pediatric asthma severity scores. No aspiration-related respiratory failure events were observed even among those receiving nutrition concurrent to noninvasive ventilation. Compared to controls, cases experienced a longer continuous albuterol duration (median: 1.1 [interquartile range: 0.7-1.8] versus 0.7 [interquartile range: 0.3-1.3] days, p<0.001). No differences in length of stay, adjunct interventions, endotracheal intubation rates, and mortality were observed between cases and controls.
Conclusion: For children hospitalized for critical asthma, oral nutrition during continuous nebulized albuterol appeared well tolerated. While prospective validation is required, the practice of withholding oral nutrition for continuous albuterol administration may be unwarranted.
期刊介绍:
Pediatric Gastroenterology, Hepatology and Nutrition (Pediatr Gastroenterol Hepatol Nutr), an official journal of The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition, is issued bimonthly and published in English. The aim of Pediatr Gastroenterol Hepatol Nutr is to advance scientific knowledge and promote child healthcare by publishing high-quality empirical and theoretical studies and providing a recently updated knowledge to those practitioners and scholars in the field of pediatric gastroenterology, hepatology and nutrition. Pediatr Gastroenterol Hepatol Nutr publishes review articles, original articles, and case reports. All of the submitted papers are peer-reviewed. The journal covers basic and clinical researches on molecular and cellular biology, pathophysiology, epidemiology, diagnosis, and treatment of all aspects of pediatric gastrointestinal diseases and nutritional health problems.