Risk factors for intensive care admission in children with severe acute asthma in the Netherlands: a prospective multicentre study

Boeschoten, Shelley A.; Boehmer, Annemie L.M.; Merkus, Peter; Rosmalen, Joost van; Jongste, Johan C. de; Fraaij, Pieter L. A.; Molenkamp, Richard; Heisterkamp, Sabien G.; Woensel, Job B. M. van; Kapitein, Berber; Haarman, Eric G.; Asperen, Roelie M. Wösten–van; Kneyber, Martin C. J.; Lemson, Joris; Hartman, Stan; Waardenburg, Dick A. van; Bunker-Wiersma, Heleen E.; Brouwer, Carole N. M.; Ewijk, Bart E. van; Landstra, Anneke M.; Verwaal, Mariel; Vaessen-Verberne, Anja; Hammer, Sebastiaan; Buysse, Corinne; Hoog, Matthijs de

doi:10.1183/23120541.00126-2020

Cited by 9 publications

(9 citation statements)

References 36 publications

(52 reference statements)

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“…Children with SAA admitted to the PICU mostly have single organ failure. We showed 14 that they have a relatively short PICU stay (mean: 3.5 days), low intubation rate (16%), and low mortality (2%) compared to the general PICU population 15‐18 . Nevertheless, a PICU admission might confront children and parents with the perception that asthma, although a chronic and often mild disease, can be fatal.…”

Section: Introductionmentioning

confidence: 85%

“…This study was the preplanned follow‐up of our nationwide multicenter prospective study, in which 221 children (aged 2‐18 years) with SAA admitted to a Dutch PICU (n = 110) or GW (n = 111) were enrolled between 2016 and 2018 14 . We prospectively identified all children (2‐18 years old) with SAA admitted to all seven Dutch academic PICUs (N = 110) and the pediatric wards of four participating general hospitals (N = 111).…”

Section: Methodsmentioning

confidence: 99%

“…This study was the preplanned follow-up of our nationwide multicenter prospective study, in which 221 children (aged 2-18 years) with SAA admitted to a Dutch PICU (n = 110) or GW (n = 111) were enrolled between 2016 and 2018. 14 We prospectively identified all children (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) years old) with SAA admitted to all seven Dutch academic PICUs (N = 110) and the pediatric wards of four participating general hospitals (N = 111). The four general hospitals were recruited based on geographical distribution over the Netherlands and needed to have a staff pediatric pulmonologist.…”

Section: Study Design and Participantsmentioning

confidence: 99%

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Quality of life and psychosocial outcomes in children with severe acute asthma and their parents

Boeschoten

Dulfer

Boehmer

et al. 2020

Pediatric Pulmonology

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Objectives: To prospectively evaluate quality of life (QoL) and psychosocial outcomes in children with severe acute asthma (SAA) after pediatric intensive care (PICU) admission compared to children with SAA who were admitted to a general ward (GW). In addition, we assessed posttraumatic stress (PTS) and asthma-related QoL in the parents. Methods: A preplanned follow-up of 3 to 9 months of our nationwide prospective multicenter study, in which children with SAA admitted to a Dutch PICU (n = 110) or GW (n = 111) were enrolled between 2016 and 2018. Asthma-related QoL, PTS symptoms, emotional and behavioral problems, and social impact in children and/or parents were assessed with validated web-based questionnaires. Results: We included 100 children after PICU and 103 after GW admission, with a response rate of 50% for the questionnaires. Median time to follow-up was 5 months (range: 1-12 months). Time to reach full schooldays after admission was significantly longer in the PICU group (mean of 10 vs 4 days, P = .001). Parents in the PICU group reported more PTS symptoms (intrusion P = .01, avoidance P = .01, arousal P = .02) compared to the GW group. Conclusion: No significant differences were found between PICU and GW children on self-reported outcome domains, except for the time to reach full schooldays. PICU parents reported PTS symptoms more often than the GW group. Therefore, monitoring asthma symptoms and psychosocial screening of children and parents after PICU admission should both be part of standard care after SAA. This should identify those who are at risk for developing PTSD, to timely provide appropriate interventions.

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Section: Introductionmentioning

confidence: 85%

Section: Methodsmentioning

confidence: 99%

Section: Study Design and Participantsmentioning

confidence: 99%

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Quality of life and psychosocial outcomes in children with severe acute asthma and their parents

Boeschoten

Dulfer

Boehmer

et al. 2020

Pediatric Pulmonology

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“…The National Review of Asthma Deaths (NRAD) had reported that two-third of the asthma deaths could be preventable if they were attentively managed in primary care 3 . Identifying children in whom a tailored asthma management may prevent PICU admission could target those with asthma symptoms for over a week, older and/or exposed to tobacco smoke 36 .…”

Section: Discussionmentioning

confidence: 99%

Asthma in paediatric intensive care in England residents: observational study

Mukherjee

Cunningham

Bhuia

et al. 2022

Sci Rep

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Despite high prevalence of asthma in children in the UK, there were no prior report on asthma admissions in paediatric intensive care units (PICU). We investigated the epidemiology and healthcare resource utilisation in children with asthma presenting to PICUs in England. PICANet, a UK national PICU database, was queried for asthma as the primary reason for admission, of children resident in England from April 2006 until March 2013. There were 2195 admissions to PICU for a median stay of 1.4 days. 59% were males and 51% aged 0–4 years. The fourth and fifth most deprived quintiles represented 61% (1329) admissions and 73% (11) of the 15 deaths. Deaths were most frequent in 10–14 years age (n = 11, 73%), with no deaths in less than 5 years age. 38% of admissions (828/2193) received invasive ventilation, which was more frequent with increasing deprivation (13% (108/828) in least deprived to 31% (260/828) in most deprived) and with decreasing age (0–4-year-olds: 49%, 409/828). This first multi-centre PICU study in England found that children from more deprived neighbourhoods represented the majority of asthma admissions, invasive ventilation and deaths in PICU. Children experiencing socioeconomic deprivation could benefit from enhanced asthma support in the community.

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“…Worldwide the number of children and teenagers requiring paediatric intensive care unit (PICU) admission has increased significantly over the past decade. 1 In England and Wales, there are 32 specialist PICU's which provide high-acuity care for critically ill children and teenagers. 2 Teenagers have been defined as young people aged between 13 and 18 years old.…”

Section: Introductionmentioning

confidence: 99%

Discharged from paediatric intensive care: A mixed methods study of teenager's anxiety levels and experiences after paediatric intensive care unit discharge

Bichard

Wray

Aitken

2021

Nursing in Critical Care

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Background: Teenagers represent a small proportion of patients on paediatric intensive care units (PICU) in the United Kingdom. During a time when their development is rapidly changing, an admission to PICU causes additional disruption. The impact of critical illness on psychological health after discharge has not been widely reported within this population.Aim and objectives: To measure anxiety that teenagers report 48-96 hours and 4 weeks after discharge from PICU. To explore teenagers' experiences of being admitted onto PICU.Design: Two-phase mixed methods, explanatory sequential design.Methods: This single-site study was conducted between February and July 2018. An NHS Ethics committee approved the study. Teenagers were screened if they were aged 13-18 years old and had an elective or emergency admission to PICU for longer than 24 hours. Hospital Anxiety and Depression Scale, Anxiety subscale (HADS-A) was administered on paper and completed with the researcher present. Semistructured interviews were conducted in-person and over the telephone, audiorecorded and transcribed verbatim. Data were analysed using inductive thematic analysis.Results: Nine of eighteen participants (50%) obtained scores indicating levels of anxiety which were mild (n = 3; 17%), moderate (n = 2; 11%), or severe (n = 4; 22%) 48-96 hours after PICU discharge. Four weeks later, all participants scored below the clinically significant cut-off level for the HADS-A-1 Teenagers described their experiences on PICU within three themes:1. Memories of treatments, side effects, and the PICU environment 2. Losing a sense of self Feeling cared forConclusions: Measured levels of anxiety had resolved in this small sample, 4 weeks after PICU discharge. This finding was not consistent with qualitative data that indicated that many experiences shared by participants were anxiety provoking.

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Risk factors for intensive care admission in children with severe acute asthma in the Netherlands: a prospective multicentre study

Cited by 9 publications

References 36 publications

Quality of life and psychosocial outcomes in children with severe acute asthma and their parents

Quality of life and psychosocial outcomes in children with severe acute asthma and their parents

Asthma in paediatric intensive care in England residents: observational study

Discharged from paediatric intensive care: A mixed methods study of teenager's anxiety levels and experiences after paediatric intensive care unit discharge

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