Abstract：
UNASSIGNED: We aimed to characterize intravenous (IV) methylprednisolone (MP) dosing regimens and clinical outcomes for children hospitalized for critical asthma (CA).
UNASSIGNED: A single-center, retrospective review was performed of children admitted to the pediatric intensive care unit (PICU) for CA between September 2015 and October 2019. Patients 5-to 17-year-olds, initiated on continuous nebulized albuterol, and prescribed at least one dose of IV MP were included. The primary outcome was to characterize PICU MP dosing. Cohorts were then compared by MP dosing: conservative-dose methylprednisolone (CDMP, ≤ 0.5 mg/kg/dose every 6 h) and standard-dose methylprednisolone (SDMP, > 0.5 mg/kg/dose every 6 h). Clinical efficacy endpoints were the duration of continuous nebulized albuterol and PICU length of stay (LOS). Safety endpoints included corticosteroid-related adverse events.
UNASSIGNED: Of 168 children studied, 50 (29.8%) were prescribed CDMP and 118 (70.2%) SDMP. The overall mean MP dose was 31.3 ± 19.6 mg (weight-adjusted: 0.77 ± 0.32 mg/kg/dose). Compared to those prescribed SDMP, those prescribed CDMP had a shorter median duration of continuous nebulized albuterol (12.8 [IQR: 10.5-20] versus 17.3 [IQR: 11.3-29.7] hours, p = 0.019) and median PICU LOS (0.9 [IQR: 0.7-1.4] versus 1.2 [IQR: 0.9-1.8] days, p = 0.012). No corticosteroid-related adverse events were observed. In adjusted models, weight-adjusted IV MP dose was not associated with PICU LOS or duration of continuous nebulized albuterol.
UNASSIGNED: Intravenous MP dosing for pediatric CA varied widely in our study sample. Prospective, controlled trials are required to validate our observations including clinical efficacy and safety endpoints.
UNASSIGNED: A single-center, retrospective review was performed of children admitted to the pediatric intensive care unit (PICU) for CA between September 2015 and October 2019. Patients 5-to 17-year-olds, initiated on continuous nebulized albuterol, and prescribed at least one dose of IV MP were included. The primary outcome was to characterize PICU MP dosing. Cohorts were then compared by MP dosing: conservative-dose methylprednisolone (CDMP, ≤ 0.5 mg/kg/dose every 6 h) and standard-dose methylprednisolone (SDMP, > 0.5 mg/kg/dose every 6 h). Clinical efficacy endpoints were the duration of continuous nebulized albuterol and PICU length of stay (LOS). Safety endpoints included corticosteroid-related adverse events.
UNASSIGNED: Of 168 children studied, 50 (29.8%) were prescribed CDMP and 118 (70.2%) SDMP. The overall mean MP dose was 31.3 ± 19.6 mg (weight-adjusted: 0.77 ± 0.32 mg/kg/dose). Compared to those prescribed SDMP, those prescribed CDMP had a shorter median duration of continuous nebulized albuterol (12.8 [IQR: 10.5-20] versus 17.3 [IQR: 11.3-29.7] hours, p = 0.019) and median PICU LOS (0.9 [IQR: 0.7-1.4] versus 1.2 [IQR: 0.9-1.8] days, p = 0.012). No corticosteroid-related adverse events were observed. In adjusted models, weight-adjusted IV MP dose was not associated with PICU LOS or duration of continuous nebulized albuterol.
UNASSIGNED: Intravenous MP dosing for pediatric CA varied widely in our study sample. Prospective, controlled trials are required to validate our observations including clinical efficacy and safety endpoints.
摘要：
目的：我们旨在描述因重症哮喘（CA）住院的儿童的静脉（IV）甲基强的松龙（MP）给药方案和临床结局。方法：单中心，我们对2015年9月至2019年10月期间因CA入住儿科重症监护病房(PICU)的儿童进行了回顾性回顾.患者5至17岁，开始于连续雾化沙丁胺醇，和处方至少包括一个剂量的IVMP。主要结果是表征PICUMP给药。然后通过MP给药比较队列：保守剂量甲基强的松龙（CDMP，每6小时<0.5mg/kg/剂）和标准剂量甲基强的松龙（SDMP，每6小时>0.5mg/kg/剂）。临床疗效终点是持续雾化沙丁胺醇的持续时间和PICU住院时间（LOS）。安全性终点包括皮质类固醇相关不良事件。结果：在接受研究的168名儿童中，50例（29.8%）患者为CDMP，118例（70.2%）患者为SDMP。总平均MP剂量为31.3±19.6mg(调整后的体重:0.77±0.32mg/kg/剂)。与规定的SDMP相比，那些开处方的CDMP连续雾化沙丁胺醇的中位持续时间较短（12.8[IQR：10.5-20]对17.3[IQR：11.3-29.7]小时，p=0.019）和中位数PICULOS（0.9[IQR：0.7-1.4]对1.2[IQR：0.9-1.8]天，p=0.012)。未观察到皮质类固醇相关的不良事件。在调整后的模型中，调整体重的IVMP剂量与PICULOS或持续雾化沙丁胺醇持续时间无关.结论：在我们的研究样本中，小儿CA的静脉MP剂量差异很大。前瞻性,需要对照试验来验证我们的观察结果,包括临床疗效和安全性终点.
