Management of severe asthma exacerbation: guidelines from the Société Française de Médecine d’Urgence, the Société de Réanimation de Langue Française and the French Group for Pediatric Intensive Care and Emergencies

Abstract Background The French Emergency Medicine Society, the French Intensive Care Society and the Pediatric Intensive Care and Emergency Medicine French-Speaking Group edited guidelines on severe asthma exacerbation (SAE) in adult and pediatric patients. Results The guidelines were related to 5 areas: diagnosis, pharmacological treatment, oxygen therapy and ventilation, patients triage, specific considerations regarding pregnant women. The literature analysis and formulation of the guidelines were conducted according to the Grade of Recommendation Assessment, Development and Evaluation methodology. An extensive literature research was conducted based on publications indexed in PubMed™ and Cochrane™ databases. Of the 21 formalized guidelines, 4 had a high level of evidence (GRADE 1+/−) and 7 a low level of evidence (GRADE 2+/−). The GRADE method was inapplicable to 10 guidelines, which resulted in expert opinions. A strong agreement was reached for all guidelines. Conclusion The conjunct work of 36 experts from 3 scientific societies resulted in 21 formalized recommendations to help improving the emergency and intensive care management of adult and pediatric patients with SAE.

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Successful Treatment of Severe Asthma Exacerbation with Sevoflurane Inhalation in the Intensive Care Unit

Journal of Anesthesia & Critical Care Open Access ◽

10.15406/jaccoa.2015.03.00092 ◽

2015 ◽

Vol 3 (2) ◽

Cited By ~ 1

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Severe Asthma ◽

Successful Treatment ◽

Asthma Exacerbation ◽

Severe Asthma Exacerbation

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Childhood Obesity Increases Duration of Therapy During Severe Asthma Exacerbation

Pediatric Critical Care Medicine ◽

10.1097/00130478-200611000-00041 ◽

2006 ◽

Vol 7 (6) ◽

pp. 616

Author(s):

&NA;

Keyword(s):

Childhood Obesity ◽

Severe Asthma ◽

Asthma Exacerbation ◽

Duration Of Therapy ◽

Severe Asthma Exacerbation

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Extracorporeal Membrane Oxygenation: The First 10 Years Experience of a Portuguese Pediatric Intensive Care Unit

Acta Médica Portuguesa ◽

10.20344/amp.15227 ◽

2021 ◽

Vol 34 (6) ◽

pp. 435

Author(s):

Daniel Meireles ◽

Francisco Abecasis ◽

Leonor Boto ◽

Cristina Camilo ◽

Miguel Abecasis ◽

...

Keyword(s):

Intensive Care Unit ◽

Overall Survival ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Pediatric Patients ◽

Life Support ◽

Extracorporeal Life Support ◽

Pediatric Intensive Care ◽

Overall Survival Rate ◽

Clinical Complications

Introduction: In Portugal, extracorporeal membrane oxygenation (ECMO) is used in pediatric patients since 2010. The aim of this study was to describe the clinical characteristics of patients, indications, complications and mortality associated with the use of ECMO during the first 10-years of experience in the Pediatric Intensive Care Unit located in Centro Hospitalar Universitário Lisboa Norte.Material and Methods: Retrospective observational cohort study of all patients supported with ECMO in a Pediatric Intensive Care Unit, from the 1st of May 2010 up to 31st December 2019.Results: Sixty-five patients were included: 37 neonatal (≤ 28 days of age) and 28 pediatric patients (> 28 days). In neonatal cases, congenital diaphragmatic hernia was the main reason for ECMO (40% of neonatal patients and 23% of total). Among pediatric patients, respiratory distress was the leading indication for ECMO (47% of total). The median length of ECMO support was 12 days. Clinical complications were more frequent than mechanical complications (65% vs 35%). Among clinical complications, access site bleeding was the most prevalent with 38% of cases. The overall patient survival was 68% at the time of discharge (65% for neonatal and 71% for pediatric cases), while the overall survival rate in Extracorporeal Life Support Organization registry was 61%. The number of ECMO runs has been increasing since 2011, even though in a non-linear way (three cases in 2010 to 11 cases in 2019).Discussion: In the first 10 years we received patients from all over the country. Despite continuous technological developments, circuitrelated complications have a significant impact. The overall survival rate in the Pediatric Intensive Care Unit was not inferior to the one reported by the Extracorporeal Life Support Organization.Conclusion: The overall survival of our Pediatric Intensive Care Unit is not inferior to one reported by other international centers. Our experience showed the efficacy of the ECMO technique in a Portuguese centre.

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Cefepime Pharmacokinetics in Critically Ill Pediatric Patients Receiving Continuous Renal Replacement Therapy

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02006-18 ◽

2019 ◽

Vol 63 (4) ◽

Author(s):

Gideon Stitt ◽

Jennifer Morris ◽

Lindsay Schmees ◽

Joseph Angelo ◽

Ayse Akcan Arikan

Keyword(s):

Intensive Care Unit ◽

Body Weight ◽

Intensive Care ◽

Retrospective Study ◽

Critically Ill ◽

Pediatric Patients ◽

Pediatric Intensive Care ◽

Free Drug ◽

Therapeutic Drug ◽

Free Drug Concentration

ABSTRACT This retrospective study included pediatric intensive care unit patients receiving continuous veno-venous hemodiafiltration (CVVHDF) being treated with cefepime. The free drug concentration above one time the MIC (fT>1×MIC) and four times a presumed MIC (fT>4×MIC) of 8 μg/ml were calculated. Four patients received doses ranging from 48 to 64 mg/kg of body weight every 6 to 12 h. Three patients achieved 100% fT>1×MIC, with the fourth patient achieving 98% fT>1×MIC. Therapeutic drug monitoring should be considered for critically ill patients receiving cefepime on CVVHDF.

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