Characterization of patients with severe asthma admitted to an intensive care unit. Descriptive study in a referral hospital
Caracterización de los pacientes con asma severa admitidos a una unidad de cuidado intensivo. Estudio descriptivo en un hospital de referencia
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OBJECTIVE: to describe the sociodemographic and clinical characteristics, as well as the complications, of patients admitted to the intensive care unit with severe asthma attacks.
METHODOLOGY: descriptive study of patients admitted to the intensive care unit with severe asthma attacks. Information concerning sociodemographic characteristics, pharmacologic management prior to hospitalization, need for invasive mechanical ventilation (IMV), pharmacologic management of the crisis, and in-hospital complications (including death) were collected over the period from January 2011 to December 2014.
RESULTS: there were 72 episodes of severe asthma attack with admission to the intensive care unit. The mean age of the patients was 42 years (interquartile range 29-59); 81% were females, and 23 patients (31,94%) were managed with IMV. The group of patients on IMVhad less time of duration of symptoms prior to the event, lower blood pH on admission and during hospitalization, and longer hospital stays. The median of days on mechanical ventilation was 2. There were two deaths due to asthma (2,78%), 3 cases of ischemic-hypoxic encephalopathy (4,17%) , and the most frequent complication was hypokalemia, which occurred in 39% of cases with IMV. Healthcareassociated pneumonia was more frequent in the group that required non-invasive mechanical ventilation (24,24%), and 2 out of 23 patients under IMV (8,7%) required tracheostomy.
CONCLUSIONS: severe asthma attacks are an important cause of admission to intensive care units in Colombia and Latin America; their morbidity rates are high, although their mortality rate is low (2,78%). Defined strategies are required to prevent these episodes and ensure timely follow-up of patients after the event.
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