Severe asthma exacerbation:Changes in patient characteristics,management,and outcomes from 1997 to 2016 in 40 ICUs in the greater Paris area  

作　　者：Romy Younan Jean Loup Augy Bertrand Hermann Bertrand Guidet Philippe Aegerter Emmanuel Guerot Ana Novara Caroline Hauw-Berlemont Amer Hamdan Clotilde Bailleul Francesca Santi Jean-Luc Diehl Nicolas Peron Nadia Aissaoui 

机构地区：[1]Intensive Care Unit,AP-HP,Georges Pompidou European Hospital,Universitéde Paris,Paris,France [2]Intensive Care Unit,AP-HP,Saint Antoine Hospital,Universités de Sorbonne,UniversitéPierre et Marie Curie,Paris,France [3]INSERM U1136,Paris,France [4]Versailles Saint-Quentin-en-Yvelines University,INSERM U1018,Groupe Interrégional de Recherche Clinique et d'Innovation,Île-de-France,France [5]Respiratory Medicine Department,AP-HP,Georges Pompidou European Hospital,Universitéde Paris,Paris,France [6]Innovative Therapies in Hemostasis,INSERM UMR-S1140,Universitéde Paris,Paris,France [7]Intensive Care Unit and Biosurgical Research Lab(Carpentier Foundation),AP-HP,Georges Pompidou European Hospital,Paris,France [8]Paris-Cardiovascular-Research-Center,INSERM U970,Paris,France

出　　处：《Journal of Intensive Medicine》2024年第2期209-215,共7页重症医学（英文）

摘　　要：Background Despite advances in asthma treatments,severe asthma exacerbation(SAE)remains a life-threatening condition in adults,and there is a lack of data derived from adult patients admitted to intensive care units(ICUs)for SAE.The current study investigated changes in adult patient characteristics,management,and outcomes of SAE over a 20-year period in 40 ICUs in the greater Paris area.Methods In this retrospective observational study,admissions to 40 ICUs in the greater Paris area for SAE from January 1,1997,to December 31,2016 were analyzed.The primary outcome was the proportion of ICU admissions for SAE during 5-year periods.Secondary outcomes were ICU and hospital mortality,and the use of mechanical ventilation and catecholamine.Multivariate analysis was performed to assess factors associated with ICU mortality.Results A total of 7049 admissions for SAE were recorded.For each 5-year period,the proportion decreased over time,with SAE accounting for 2.84%of total ICU admissions(n=2841)between 1997 and 2001,1.76%(n=1717)between 2002 and 2006,1.05%(n=965)between 2007 and 2011,and 1.05%(n=1526)between 2012 and 2016.The median age was 46 years(interquartile range[IQR]:32–59 years),55.41%were female,the median Simplified Acute Physiology Score II was 20(IQR:13–28),and 19.76%had mechanical ventilation.The use of mechanical ventilation remained infrequent throughout the 20-year period,whereas the use of catecholamine decreased.ICU and hospital mortality rates decreased.Factors associated with ICU mortality were renal replacement therapy,catecholamine,cardiac arrest,pneumothorax,acute respiratory distress syndrome,sepsis,and invasive mechanical ventilation(IMV).Non-survivors were older,had more severe symptoms,and were more likely to have received IMV.Conclusion ICU admission for SAE remains uncommon,and the proportion of cases decreased over time.Despite a slight increase in symptom severity during a 20-year period,ICU and hospital mortality decreased.Patients requiring IMV had a higher mortality rate.

关 键 词：EPIDEMIOLOGY Intensive care unit Mechanical ventilation Severe asthma exacerbation 

分 类 号：R562.25[医药卫生—呼吸系统]