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Continuous Albuterol in Pediatric Acute Care: Study Demonstrates Safety Outside the Intensive Care Unit

There are little data to support the use of continuous aerosolized albuterol (CAA) in the non-intensive care unit (ICU) or non-emergency department (ED) setting for pediatric asthma patients. A 2014 study demonstrated low rates of adverse outcomes associated with administration of CAA on the acute c...

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Autores principales: Messer, Amanda F., Sampayo, Esther M., Mothner, Brent, Camp, Elizabeth A., Jones, Jennifer, Brown, Terri, Vachani, Joyee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946228/
https://www.ncbi.nlm.nih.gov/pubmed/32010852
http://dx.doi.org/10.1097/pq9.0000000000000225
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author Messer, Amanda F.
Sampayo, Esther M.
Mothner, Brent
Camp, Elizabeth A.
Jones, Jennifer
Brown, Terri
Vachani, Joyee
author_facet Messer, Amanda F.
Sampayo, Esther M.
Mothner, Brent
Camp, Elizabeth A.
Jones, Jennifer
Brown, Terri
Vachani, Joyee
author_sort Messer, Amanda F.
collection PubMed
description There are little data to support the use of continuous aerosolized albuterol (CAA) in the non-intensive care unit (ICU) or non-emergency department (ED) setting for pediatric asthma patients. A 2014 study demonstrated low rates of adverse outcomes associated with administration of CAA on the acute care unit; however, the authors do not describe additional outcomes. We sought to determine whether administration of CAA within a respiratory cohort on an acute care floor was feasible and safe. METHODS: This quasi-experimental study evaluates data 1 year before and after (2014–2016) the initiation of CAA on the acute care inpatient unit for asthma patients 2−18 years of age. Outcome measures included ED and hospital length of stay (LOS), readmission rate, rapid response team activations, and transfers to ICU. Use of chest x-rays, viral studies, and hospital charges were also studied. RESULTS: Seven hundred thirty-two patients met study criteria. Population demographics and severity of acute presentation were similar pre- and poststudy. ED LOS decreased poststudy, whereas overall hospital LOS was unchanged. Fifteen-day readmission rate decreased in the poststudy group. Only 4 rapid response activations occurred in the poststudy population. The poststudy group utilized fewer chest x-rays and viral studies. There was no change in overall hospital charges. CONCLUSIONS: With appropriate resources and safety processes in place, care of pediatric patients with status asthmaticus receiving CAA on an acute care unit, outside of the ICU, resulted in improved ED LOS with evidence of lower resource utilization and rare adverse outcomes.
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spelling pubmed-69462282020-01-31 Continuous Albuterol in Pediatric Acute Care: Study Demonstrates Safety Outside the Intensive Care Unit Messer, Amanda F. Sampayo, Esther M. Mothner, Brent Camp, Elizabeth A. Jones, Jennifer Brown, Terri Vachani, Joyee Pediatr Qual Saf Individual QI Projects from Single Institutions There are little data to support the use of continuous aerosolized albuterol (CAA) in the non-intensive care unit (ICU) or non-emergency department (ED) setting for pediatric asthma patients. A 2014 study demonstrated low rates of adverse outcomes associated with administration of CAA on the acute care unit; however, the authors do not describe additional outcomes. We sought to determine whether administration of CAA within a respiratory cohort on an acute care floor was feasible and safe. METHODS: This quasi-experimental study evaluates data 1 year before and after (2014–2016) the initiation of CAA on the acute care inpatient unit for asthma patients 2−18 years of age. Outcome measures included ED and hospital length of stay (LOS), readmission rate, rapid response team activations, and transfers to ICU. Use of chest x-rays, viral studies, and hospital charges were also studied. RESULTS: Seven hundred thirty-two patients met study criteria. Population demographics and severity of acute presentation were similar pre- and poststudy. ED LOS decreased poststudy, whereas overall hospital LOS was unchanged. Fifteen-day readmission rate decreased in the poststudy group. Only 4 rapid response activations occurred in the poststudy population. The poststudy group utilized fewer chest x-rays and viral studies. There was no change in overall hospital charges. CONCLUSIONS: With appropriate resources and safety processes in place, care of pediatric patients with status asthmaticus receiving CAA on an acute care unit, outside of the ICU, resulted in improved ED LOS with evidence of lower resource utilization and rare adverse outcomes. Wolters Kluwer Health 2019-12-05 /pmc/articles/PMC6946228/ /pubmed/32010852 http://dx.doi.org/10.1097/pq9.0000000000000225 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Individual QI Projects from Single Institutions
Messer, Amanda F.
Sampayo, Esther M.
Mothner, Brent
Camp, Elizabeth A.
Jones, Jennifer
Brown, Terri
Vachani, Joyee
Continuous Albuterol in Pediatric Acute Care: Study Demonstrates Safety Outside the Intensive Care Unit
title Continuous Albuterol in Pediatric Acute Care: Study Demonstrates Safety Outside the Intensive Care Unit
title_full Continuous Albuterol in Pediatric Acute Care: Study Demonstrates Safety Outside the Intensive Care Unit
title_fullStr Continuous Albuterol in Pediatric Acute Care: Study Demonstrates Safety Outside the Intensive Care Unit
title_full_unstemmed Continuous Albuterol in Pediatric Acute Care: Study Demonstrates Safety Outside the Intensive Care Unit
title_short Continuous Albuterol in Pediatric Acute Care: Study Demonstrates Safety Outside the Intensive Care Unit
title_sort continuous albuterol in pediatric acute care: study demonstrates safety outside the intensive care unit
topic Individual QI Projects from Single Institutions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946228/
https://www.ncbi.nlm.nih.gov/pubmed/32010852
http://dx.doi.org/10.1097/pq9.0000000000000225
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