Outcomes Good for Status Asthmaticus Patients in ICU
(HealthDay News) – Although the majority of patients admitted to the intensive care unit (ICU) with status asthmaticus (SA) require mechanical ventilation, the rates of mortality and complications are very low, according to a study published in the March issue of Respiratory Medicine.
Jay I. Peters, MD, from the University of Texas Health Science Center in San Antonio, and colleagues conducted a retrospective observational study of 227 patients admitted to a single medical ICU with 280 episodes of SA over a 30-year period. The characteristics, trends in management, and their impact on complications and outcomes in SA were assessed.
The investigators found that African-Americans were overrepresented (22%) and Caucasians underrepresented (21%), compared to the regional population (52% Hispanic). Of the participants, 38%, 27%, and 18% reported childhood asthma, were steroid dependent, and had a recent steroid taper, respectively. On admission, 61.2% of patients needed intubation. Hospital duration was similar for patients who were and were not mechanically ventilated (average, 5.8 and 6.8 days, respectively; P=0.07). Irrespective of permissive hypercapnia or mode of mechanical ventilation, the overall complication rate remained low (overall mortality, 0.4%; pneumothorax, 2.5%; pneumonia, 2.9%). Over the last 10 years of the study period, there was a significant decrease in the frequency of SA (12.4 vs. 3.2 cases per year).
"Our study demonstrates that outcomes for SA should be good/excellent once patients reach the ICU," the authors write. "Despite our frequent use of mechanical ventilation, mortality and complications remained low. Additionally, mechanical ventilation did not significantly increase the duration of hospitalization."