A ten - year study on in the intensive care unit of Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan
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Date
2001-11
Authors
Ahmad, Rashidi
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Acute exacerbation of severe asthma is a common presentation to the
Emergency Department, hospital, and Intensive Care Unit admission.
This study will review asthma patients that admitted into the intensive care
unit of Hospital Universiti Sains Malaysia. By studying the demographic
characteristics or patients' profile, and the precipitating factors, we can
predict those asthmatics that will deteriorate or develop severe asthma
symptoms. This is very important and essential to prevent the morbidity
and mortality and to improve the outcome.
The main objectives of this study are:
1. To analyze and identify the demographic characteristics of
asthma patients that required admission into Intensive Care
Unit.
2. ·To identify the common predisposing factors for severe
asthma that required intensive care management
3. To identify the risk factors for severe asthma that admitted
for mechanical ventilatory support.
This is a 10-year observational study from 1999 to a 2000. All asthma
cases that were admitted into Hospital University Science Malaysia
Intensive Unit Care were included in the study. Variables on study were
demographic characteristics, past medical history, allergic history,
medications, and severity of illness, precipitating factors, compliance,
complications, duration of stay, ventilation or observation and others.
There were 103 asthma cases in this study. Predominate by female
patients (60.2o/o). Age group between 30 to 34 years old had a highest
ICU admission. Mean age was 33 years old. 76o/o of the subjects were
non-smoking asthma patients. 61.2°/o of the subjects were self-referred,
77.3o/o had a positive family history of asthma, and 58.1o/o had moderate
severity of chronic asthma. Precipitating factors were upper respiratory
tract infection (51.5o/o) and .P~eumonia (28.2o/o). 74.8o/o of subjects had
previous history of hospital admission and 36. 9o/o had previous history of
ICU admission. 73o/o had a poor compliance to medication, and 79.8o/o had
improper technique of using the inhaler. 35°/o of the subjects had
hypokalaemia and 16.5o/o had a hypoxic fit. Other complications were
pneumonia, arrythmias, and pneumothorax. 85°/o of subjects stayed less
than 4 days in ICU. Majority of subjects responded to standard asthma
therapy.
The great challenge in managing acute asthma patients in ED is to
prevent the recurrence of asthma attack, to decide whether the required
admission or not, and to prevent mortality. Our data showed middle and
old asthma patients, sudden onset of severe asthma, severe chronic
asthma, poor compliance, poor inhaler technique, history of hospital
admission and ICU admission were important risk factors for the
develoment of acute severe asthma. Upper respiratory infections and
pneumonia were common precipitating factors of acute severe asthma.
Regarding the risk for ventilation we noted it has a significant correlation
or association with age, severity of chronic asthma, history of
hospitalization, and ICU admission. Number of ventilated patients was
high in middle age group, severe chronic asthma, those with a history of
hospitalization and ICU admission, and also in those poor compliance
patients and those who can't perform the technique of inhalation properly.
Majority of the patients that admitted into ICU responded to standard
therapy. The complications were minimal. These patients usually recover
very fast and majorities of them stayed just for a few days in ICU.
Description
Keywords
Asthma