An Innovative Childhood Asthma Score Predicts the Need for Bronchodilator Nebulization in Children With Acute Asthma Independent of Auscultative Findings

Kamps, Arvid W A; Veeger, Nic J. G. M.; Heijsman, Sigrid M.

doi:10.4187/respcare.02991

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…Among our enrolled 95 children aged between 6-12 years, 52.1% patients were females and 47.9% were males, which show that incidence is nearly the same in two genders. Kamps et al while studying children 2-18 years of age, had also reported equal distribution of asthma in either gender in Netherlands as affected males were 49% 16 . 67.4% of our patients were found to have a positive family history for asthma.…”

Section: Discussionmentioning

confidence: 92%

“…Asthma is a common phenomenon in many families as the disease course of this chronic entity is marked with episodic exacerbations. Severe exacerbation does require management in the emergency department or even inpatient hospitalization 16 . Timely, yet effective, intervention can direct us towards limiting its morbidity and lesser hospital indoor stays.…”

Section: Discussionmentioning

confidence: 99%

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EFFICACY OF SALBUTAMOL DELIVERED THROUGH A METERED DOSE INHALER & SPACER IN CHILDREN WITH ACUTE EXACERBATION OF ASTHMA

Tahir

Akhtar

Balooch

et al. 2021

PAFMJ

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Objective: To assess efficacy of salbutamol delivered through metered dose inhaler (MDI) - spacer in paediatric patients with acute exacerbation of asthma. Study Design: Prospective observational study. Place and Duration of Study: Department of Paediatrics, Pakistan Naval Ship, Shifa Hospital, Karachi-Pakistan, from Jan to Dec 2018. Methodology: Ninety Five patients aged ≥6 to ≤12 years, with acute asthma exacerbation were enrolled. Any patient with fever, clinical asthma score (CAS) >7, on home treatment with drugs delivered through nebulization or on oral steroids was excluded. Clinical asthma score recorded on presentation, followed with salbutamol via Metered Dose Inhaler & spacer at dose of 400 µgm (4 x puffs of 100 µgm). Clinical asthma score rechecked after 20 min. Response to salbutamol was then compared in relation to the presenting Clinical asthma score. Results: Out of 95 children, 45 (47.9%) were male & 50 (52.1%) female with 67.4% having positive family history for asthma. Average premedication clinical asthma score was 2.44. Sixty nine (72.9%) patients had an adequate response as they exhibited clinical asthma score of 0 or fall in score of ≥2. Patients with adequate response had average clinical asthma score of 2.07 on presentation in contrast to 3.42 with inadequate response. Conclusion: Salbutamol delivered via Metered Dose Inhaler & spacer at dose of 400 µgm is an effective medication for quick relief in children with acute exacerbation of asthma. Moreover, its administration at a point where exacerbation is not much severe steers us towards more favourable outcome.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

EFFICACY OF SALBUTAMOL DELIVERED THROUGH A METERED DOSE INHALER & SPACER IN CHILDREN WITH ACUTE EXACERBATION OF ASTHMA

Tahir

Akhtar

Balooch

et al. 2021

PAFMJ

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“…The primary outcome was the asthma severity. There are multiple scores for assessing asthma severity, namely the Pulmonary Index Score, 13 Pediatric Asthma Severity Score, 14 Childhood Asthma Score 15 and the Pediatric Respiratory Assessment Measure. 16 All these scores are on an ordinal scale where increasing scores mean increasing disease severity.…”

Section: Discussionmentioning

confidence: 99%

Role of nebulised magnesium sulfate in treating acute asthma in children: a systematic review and meta-analysis

Kumar,

Goyal

et al. 2024

bmjpo

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ObjectivesTo review the efficacy of nebulised magnesium sulfate (MgSO4) in acute asthma in children.MethodsThe authors searched Medline, Embase, Web of Science and Cochrane Library for randomised controlled trials (RCTs) published until 15 December 2023. RCTs were included if they compared the efficacy and safety of nebulised MgSO4as a second-line agent in children presenting with acute asthma exacerbation. A random-effects meta-analysis was performed, and the Risk of Bias V.2 tool was used to assess the biases among them.Results10 RCTs enrolling 2301 children with acute asthma were included. All trials were placebo controlled and administered nebulised MgSO4/placebo and salbutamol (±ipratropium bromide). There was no significant difference in Composite Asthma Severity Score between the two groups (6 RCTs, 1953 participants; standardised mean difference: −0.09; 95% CI: −0.2 to +0.02, I2=21%). Children in the MgSO4group have significantly better peak expiratory flow rate (% predicted) than the control group (2 RCTs, 145 participants; mean difference: 19.3; 95% CI: 8.9 to 29.8; I2=0%). There was no difference in the need for hospitalisation, intensive care unit admission or duration of hospital stay. Adverse events were minor, infrequent (7.3%) and similar among the two groups.ConclusionsThere is low-certainty evidence that nebulised MgSO4as an add-on second-line therapy for acute asthma in children does not reduce asthma severity or a need for hospitalisation. However, it was associated with slightly better lung functions. The current evidence does not support the routine use of nebulised MgSO4in paediatric acute asthma management.PROSPERO registration numberCRD42022373692.

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“…Physical examination and medical history, including previous attacks and comorbidities ( Table 3 ), are the cornerstones to assess the severity of the exacerbation and the need for ER evaluation [ 3 , 11 , 19 ]. The objective datum of oxygen saturation by pulse oximetry is crucial to support the diagnosis and evaluate asthma attack [ 23 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. When the response to SABA is scarce within the first hour of treatment, the patient should be sent to the ER.…”

Section: Discussionmentioning

confidence: 99%

“…During an acute asthma attack, the measurement of lung function by FEV 1 (forced expiratory volume in 1 s) or PEF is strongly recommended whenever possible, without delaying therapy. These tests define the severity of the attack (mild for PEF or FEV 1 values >80%, moderate for values between 60 and 80% and severe if PEF or FEV 1 are <60%) and assess the response to therapy [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ...…”

Section: Discussionmentioning

confidence: 99%

Management of Children with Acute Asthma Attack: A RAND/UCLA Appropriateness Approach

Fainardi

Caffarelli

Bergamini

et al. 2021

IJERPH

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Bronchial asthma is the most frequent chronic disease in children and affects up to 20% of the pediatric population, depending on the geographical area. Asthma symptoms vary over time and in intensity, and acute asthma attack can resolve spontaneously or in response to therapy. The aim of this project was to define the care pathway for pediatric patients who come to the primary care pediatrician or Emergency Room with acute asthmatic access. The project was developed in the awareness that for the management of these patients, broad coordination of interventions in the pre-hospital phase and the promotion of timely and appropriate assistance modalities with the involvement of all health professionals involved are important. Through the application of the RAND method, which obliges to discuss the statements derived from the guidelines, there was a clear increase in the concordance in the behavior on the management of acute asthma between primary care pediatricians and hospital pediatricians. The RAND method was found to be useful for the selection of good practices forming the basis of an evidence-based approach, and the results obtained form the basis for further interventions that allow optimizing the care of the child with acute asthma attack at the family and pediatric level. An important point of union between the primary care pediatrician and the specialist hospital pediatrician was the need to share spirometric data, also including the use of new technologies such as teleconsultation. Monitoring the progress of asthma through spirometry could allow the pediatrician in the area to intervene early by modifying the maintenance therapy and help the patient to achieve good control of the disease.

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An Innovative Childhood Asthma Score Predicts the Need for Bronchodilator Nebulization in Children With Acute Asthma Independent of Auscultative Findings

Cited by 6 publications

References 13 publications

EFFICACY OF SALBUTAMOL DELIVERED THROUGH A METERED DOSE INHALER & SPACER IN CHILDREN WITH ACUTE EXACERBATION OF ASTHMA

EFFICACY OF SALBUTAMOL DELIVERED THROUGH A METERED DOSE INHALER & SPACER IN CHILDREN WITH ACUTE EXACERBATION OF ASTHMA

Role of nebulised magnesium sulfate in treating acute asthma in children: a systematic review and meta-analysis

Management of Children with Acute Asthma Attack: A RAND/UCLA Appropriateness Approach

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