Clinical Predictors of Intensive Care Unit Admission for Asthmatic Children

Abstract

Introduction Children with severe asthma attack are a challenging group of patients who could be difficult to treat and leading to significant morbidity and mortality. Asthma attack severity is qualitatively estimated as mild, moderate and severe attacks and respiratory failure based on conditions such as respiration status, feeling of dyspnea, and the degree of unconsciousness. Part of which are subjective rather than objective. We investigated clinical findings as predictors of severe attack and probable requirement for Pediatric Intensive Care Unit (PICU) admission. Materials and Methods In a cross sectional and analytical study, 120 patients with asthma attack were enrolled from April 2010 to April 2014 (80 admitted in the pediatric ward and 40 in Pediatric Intensive Care Unit). Predictors of PICU admission were investigated regarding to initial Heart Rate (HR), Respiratory Rate (RR), Oxygen Saturation in Arterial Blood (SaO2) and Partial Pressure of Carbon Dioxide in Arterial Blood (PaCo2) and clinically evident cyanosis. Results Initial heart rate (P=0.02), respiratory rate (P=0.03), Arterial oxygen saturation (P=0.02) and PaCo2 (P=0.03) and clinically evident cyanosis were significantly different in two groups (Ward admitted and PICU admitted). Conclusion There was a significant correlation between initial vital sign and blood gas analysis suggesting usefulness of these factors as predictors of severe asthma attack and subsequent clinical course.