Evidence map›Paper›PMID 38290751›Full record

ArticleRespiratory care2024

Noninvasive Respiratory Support for Pediatric Critical Asthma: A Multicenter Cohort Study.

Brett W Russi, Alexa R Roberts, Ignacio F Nievas, Colin M Rogerson, John M Morrison, Anthony A Sochet

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Respiratory care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
4.2field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Brett W RussiDivision of Pediatric Critical Care Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
Alexa R RobertsDivision of Pediatric Critical Care Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
Ignacio F NievasDivision of Pediatric Critical Care Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
Colin M RogersonDivision of Pediatric Critical Care Medicine, Indiana University School of Medicine and Riley Hospital for Children at IU Health, Indianapolis, Indiana.
John M MorrisonDepartment of Pediatrics, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
Anthony A SochetDepartment of Anesthesia and Critical Care Medicine, Johns Hopkins University School of Medicine, St. Petersburg, Florida. Anthony.Sochet@jhmi.edu.
Johns Hopkins University · USRiley Hospital for Children · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNoninvasive respiratory support (NRS) for pediatric critical asthma includes CPAP; bi-level positive airway pressure (BPAP); and heated, humidified, high-flow nasal cannula (HFNC). We used the Virtual Pediatric System database to estimate NRS by prescribing rates for pediatric critical asthma and characterize patient clinical features and in-patient outcomes by the initial NRS device applied.

methodsWe performed a retrospective cohort study from 125 participating pediatric ICUs among children 2-17 years of age hospitalized for critical asthma and prescribed NRS from 2017 through 2021. The primary outcomes were NRS modality prescribing rates and trends. Secondary outcomes were descriptive and included demographics, comorbidities, severity of illness indices, and NRS failure rates (defined as escalation from the initial NRS modality to invasive ventilation, HFNC to BPAP or CPAP, or CPAP to BPAP).

resultsOf the 10,083 encounters studied, the initial NRS modalities prescribed varied widely by hospital center (HFNC: 69.7 ± 29.6%; BPAP: 27.2 ± 7.1%; CPAP: 3.1 ± 5.9%). The mean rates of HFNC use increased from 59.7% in 2017 to 71.9% in 2021 (+2.5%/y). In contrast, BPAP (-1.6%/y) and CPAP (-0.8%/y) utilization declined throughout the study period. Older children who were obese and with a higher Pediatric Risk of Mortality III-Probability of Mortality score were more frequently prescribed BPAP and CPAP compared with HFNC. Those children on HFNC experienced higher noninvasive respiratory support failure rates versus BPAP (7.3% vs 2.4%;

conclusionsIn this multi-center cohort study, we observed that children with critical asthma are increasingly exposed to HFNC compared with BPAP and CPAP. Rates of HFNC failure were greater than those of BPAP failure, but a majority were transitioned to BPAP without subsequent invasive ventilation. The next steps include prospective trials, including practical end points such as patient comfort and optimal delivery of nebulized treatments to distinguish device superiority and suitable NRS utilization.

Indexed as

AsthmaNoninvasive VentilationAdolescentCannulaChildChild, PreschoolCohort StudiesContinuous Positive Airway PressureCritical IllnessFemaleHumansIntensive Care Units, PediatricMaleRetrospective StudiesSeverity of Illness IndexAsthmaBilevel positive airway pressureContinuous positive airway pressureCritical asthmaHigh-flow nasal cannulaInvasive ventilationNoninvasive respiratory supportNoninvasive ventilationPediatricStatus asthmaticus

Identifiers

PMID38290751
PMCPMC11147613
OpenAlexW4391362593

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.