Prevalence and risk factors of lactic acidosis in children with acute moderate and severe asthma, a prospective observational study.

Details

Serval ID
serval:BIB_6A652F8677C7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prevalence and risk factors of lactic acidosis in children with acute moderate and severe asthma, a prospective observational study.
Journal
European journal of pediatrics
Author(s)
Ruman-Colombier M., Rochat Guignard I., Di Paolo E.R., Gehri M., Pauchard J.Y.
ISSN
1432-1076 (Electronic)
ISSN-L
0340-6199
Publication state
Published
Issued date
2021
Peer-reviewed
Oui
Volume
180
Pages
1125-1131
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Lactic acidosis is a common complication of status asthmaticus in adults. However, data is sparse in children. The aim of this study was to describe the prevalence and risk factors for lactic acidosis in children hospitalised for acute moderate or severe asthma. A total of 154 children 2-17 years of age were enrolled in a prospective observational study conducted in a tertiary hospital. All had capillary blood gas assessment 4 h after the first dose of salbutamol in hospital. The primary endpoint was the prevalence of lactic acidosis. Potential contributing factors such as age, sex, BMI, initial degree of asthma severity, type of salbutamol administration (nebuliser or inhaler), steroids, ipratropium bromide, and glucose-containing maintenance fluid represented secondary endpoints. All in all, 87% of patients had hyperlactatemia (lactate concentration > 2.2 mmol/l). Lactic acidosis (lactate concentration > 5 mmol/l and anion gap ≥ 16 mmol/l) was observed in 26%. In multivariate analysis, age more than 6 years (OR = 2.8, 95% CI 1.2-6.6), glycemia above 11 mmol/l (OR = 3.2 95% CI 1.4-7.4), and salbutamol administered by nebuliser (OR = 10, 95% CI 2.7-47) were identified as risk factors for lactic acidosis in children with moderate or severe asthma.Conclusion: Lactic acidosis is a frequent and early complication of acute moderate or severe asthma in children. What is Known: • Lactic acidosis during acute asthma is associated with b2-mimetics administration. • Salbutamol-related lactic acidosis is self-limited but important to recognise, as compensatory hyperventilation of lactic acidosis can be mistaken for respiratory worsening and lead to inappropriate supplemental bronchodilator administration. What is New: • Lactic acidosis is a frequent complication of acute asthma in the paediatric population. • Age older than 6 years, hyperglycaemia, and nebulised salbutamol are risk factors for lactic acidosis during asthma.
Keywords
Asthma, Lactic acidosis, Paediatrics, Salbutamol
Pubmed
Web of science
Open Access
Yes
Create date
02/11/2020 14:48
Last modification date
17/03/2021 7:26
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