Source: Annual Congress 2010 - Acute respiratory failure
Disease area: Respiratory critical care

Abstract

Introduction
Severe acute asthma is a medical emergency with which there are patient characteristics recognised to be associated,and a proportion are admitted to Intensive Care Unit(ICU) despite optimal medical therapy.
Aims
To characterise the patients admitted to ICU with severe asthma and determine treatment and clinical outcome.
Methods
Retrospective data collection of asthmatic patients admitted to ICU from August 2006-June 2009 at Buckinghamshire Hospitals NHS Trust,identified by ICU database.
Results
21 admissions were identified involving 16 patients.Using BTS asthma-control step-stages pre-admission:6% was Step 1,19-31% Steps 2-5.12(75%) were admitted once during study period,3 twice(Step 4-5);1 thrice(Step 5).94% were female;median age of 34 yrs and median weight of 84kg(range 67 – 115kg).44% were current or ex-smokers.56% had previous admission/s in the past year while 19% had never been admitted.Management in ICU:43% sufficed with optimal medical therapy,14% required NIV/CPAP,48% were intubated,of which 20% led to tracheostomy.Median ITU stay was 3 days(range 1 – 56 days).Complications included failed 1^st intubation(N=2) and vocal cord palsy(N=1).There was 1 mortality at follow-up(uterine cancer) of 8mths-3.5 yrs.
Conclusions:
Results illustrate trends & associations including a striking female preponderance;majority are overweight;positive association of severe asthma with previous hospital admission/s in the past year and positive smoking status;recurrent admission/s appear to correlate with ‘STEP-severity‘.Asthma was appropriately managed in ICU,with very low incidence of complications and one unrelated mortality.Mechanical ventilation is rarely prolonged in majority of cases.

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Citations should be made in the following way:
D. Lau, M. Shahidi (High Wycombe, United Kingdom). ICU admissions for severe acute asthma – An experience in a hospital trust in Buckinghamshire, UK. Eur Respir J 2010; 36: Suppl. 54, 2294

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