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

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Serval ID
serval:BIB_FC04EBE909A4
Type
PhD thesis: a PhD thesis.
Collection
Publications
Institution
Title
Prevalence and risk factors of lactic acidosis in children with acute moderate and severe asthma, a prospective observational study
Author(s)
Ruman-Colombier Marta
Director(s)
Gehri Mario, Pauchard Jean-Yves
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2021
Language
english
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.
Create date
04/10/2021 10:36
Last modification date
11/11/2021 10:07
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