It has emerged that children with status asthmaticus may safely be able to reduce their daily corticosteroid dose. Status asthmaticus is a condition where patients those who experience prolonged and serious asthma attacks.
Researchers from Kosair Children's Hospital in Kentucky conducted before and after chart reviews of 292 patients younger than 18 years who were hospitalized with status asthmaticus. Eligible patients had received methylprednisolone, prednisolone, or prednisone. Steroid dosing for group 1 (152 patients) was 1 mg/kg/dose every 6 hours (maximum of 240 mg/day) and 0.5 to 1 mg/kg/dose every 12 hours (maximum of 60 mg/day) for group 2 (141 patients). The average length of hospital stay for was 2.01 days for group 1 and 1.98 days for group 2, suggesting there was no effect on length of stay. Researchers conclude that decreasing the daily dose of systemic corticosteroids for status asthmaticus does not affect the length of hospital stay.
High-Dose Inhaled Albuterol Associated With Metabolic Acidosis
(#8423, Tuesday, November 3, 3:45 PM ET)
Patients with severe acute asthma may be at a higher risk of developing metabolic acidosis, an excess of acid in the blood. In a retrospective analysis, researchers from Yale School of Medicine reviewed demographic and physiologic data of 201 pediatric patients (younger than18 years) admitted to the pediatric ICU with a diagnosis of severe acute asthma. Results showed that heart rate and respiratory rate were higher in patients receiving high-dose albuterol (>10 mg/h), and 14 patients (33 percent) developed metabolic acidosis. In addition, 13 patients (43.3 percent) receiving high-dose albuterol developed metabolic acidosis compared with one patient (8.3 percent) receiving low-dose (<10 mg/h) inhaled albuterol. There was no difference between age, gender, duration of symptoms before hospital presentation, and pediatric risk of mortality score between patients on high-dose and low-dose albuterol.
Tonsil Size May Predict Sleep Apnea in Kids
(#8090, Tuesday, November 3, 3:45 PM ET)
Children with large tonsils may be at an increased risk of developing obstructive sleep apnea-hypopnea syndrome (OSAHS). Researchers from the Philippines assessed the link between obesity and OSAHS in 285 children who snored. Of the patients, 118 patients (41 percent) were found to be obese. Among the obese patients, 34 percent had OSAHS, while 50 percent of patients who were not obese also had the condition. Results indicated that the BMI Z-score, a measure of obesity, did not demonstrate a significant risk factor or predictor for the presence and severity of OSAHS. Yet, tonsillar size, the presence of witnessed apneas in the sleep history, and presence of nasal congestion due to allergic rhinitis were found to be significant risk factors for the presence of OSAHS.