Open AccessThe use of the association of bronchodilators in the management of moderate/severe asthma attacks in the pediatric emergency of a reference hospital in the Federal District
Author(s) -
Tatiana Miguel Rodrigues,
Lisliê Souza
Publication year - 2021
Publication title -
residência pediátrica
Language(s) - English
Resource type - Journals
ISSN - 2236-6814
DOI - 10.25060/residpediatr-2021.v11n1-120
Subject(s) - medicine , ipratropium bromide , bronchodilator , asthma , emergency department , oxygen therapy , observational study , acute severe asthma , statistical significance , medical record , pediatrics , emergency medicine , anesthesia , respiratory disease , lung , psychiatry
Treatment instituted in the care of the child with asthma/wheezing exacerbations may influence clinical outcome and should take the severity of condition into consideration. In moderate/severe exacerbations, residual bronchoconstriction often results in refractory high doses of beta-2-agonists, and the association of bronchodilators is indicated. OBJECTIVES: To analyze the clinical outcome obtained with the use of the association of bronchodilators in management of moderate to severe asthma/wheezing episodes in the pediatric emergency regarding the need for hospitalization, duration of oxygen supplementation, length of hospital stay and transfer to the ICU. METHODS: A retrospective cross-sectional observational study was carried out by reviewing the medical records of patients with moderate to severe wheezing/asthma episodes in the pediatric emergency of the Hospital Materno Infantil of Brasília, from March 2017 to August 2017. Patients that used bronchodilator monotherapy with beta-2-agonists were compared with those who received the combination of bronchodilators, ipratropium bromide, and beta-2-agonists, through the chi-square independence test. RESULTS: All patients selected (129 patients) were hospitalized after initial care. Three patients were transferred to the ICU and one died, with no statistical relation to the therapy. Those who used bronchodilator association generally had a shorter hospital stay and oxygen therapy, but there was no statistically significant difference between the groups (p=0.55 e 0.21, respectively). CONCLUSIONS: No statistical significance was observed between the therapeutic groups and the clinical outcomes analyzed, although shorter hospital stay and oxygen therapy were observed in the group that used the bronchodilator combination.