Assessment of the Severity of Acute Asthma Exacerbation in Children Attending the Emergency Departments to Predict Outcomes by Modified Pulmonary Index Score
试验速览
- 阶段
- 不适用
- 入组人数
- 1
- 主要终点
- ICU admission according to oxygen saturation <81%, respiratory rate <6years old = >60 ≥6years old = >50 and heart rate <3 years old = >160 ≥3 years old= >140
研究概览
简要总结
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity, together with variable expiatory airflow limitation. This definition was reached by consensus, based on consideration of the characteristics that are typical of asthma and that distinguish it from other respiratory conditions .
Asthma is a problem worldwide, with an estimated 300 million affected individuals .It appears that the global prevalence of asthma ranges from 1% to 18% of the population in different countries .
详细描述
Over the past years, an increase in the number of emergency department (ED) visits for asthma exacerbation has been reported. Most of these visits are for preschool children.
Although pulmonary function tests are commonly used to assess the severity of acute asthma in adults, they are difficult to perform in children, especially those who are younger than five years old .
spirometry measures pulmonary markers such as vital capacity and maximal forced expiatory volume in 1 second. Well-trained personnel are required to perform these tests, and they are not routinely available in the ED. Peak flow has been used in the ED to measure the degree of respiratory obstruction .This technique is difficult to perform in children less than 6 years of age because of their lack of coordination and comprehension .
Adequate evaluation of the severity of asthma exacerbation is important for the initial management of patients, as well as for assessing the clinical response. However, severity is more difficult to assess in children. The clinical evaluation and physician's experience are often not enough to determine the degree of respiratory obstruction .
In the emergency room setting, the most critical issue facing the attending physician is, deciding the adequacy of outpatient therapy of acute asthma, or when hospitalization is indicated. Traditionally, this decision is used to be made according to the clinical history, physical examination, laboratory results and response to therapy of the patient .
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Prospective
入排标准
- 年龄范围
- 1 Year 至 17 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •children with acute asthma exacerbation
- •children with acute asthma aged 1-17 years old
- •background history of asthma
- •this study will deal with the protocols applied in Assiut university children hospital
排除标准
- •children below age of 1 year and more than 17 years old
- •Known Tuberculosis exposure
- •concurrent stridor
- •use of oral corticosteroids in the previous four weeks
- •Significant co-morbid disease : lung ,cardiac ,immune , liver , endocrine ,neurological or psychiatric
- •children with other causes of respiratory distress
- •Children with mild or controlled asthma.
结局指标
主要结局
ICU admission according to oxygen saturation <81%, respiratory rate <6years old = >60 ≥6years old = >50 and heart rate <3 years old = >160 ≥3 years old= >140
时间窗: within 15 minute
Adequate evaluation of the severity of asthma exacerbation is important for the initial management of patients,using clinical parameters to decide ICU admission :oxygen saturation ,heart rate,respiratory rate and Degree of agitation and conscious level.
次要结局
- hospital stay(within one week)
研究者
Hend Heshmat
prinicpal investigator
Assiut University