PMID- 37533610
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230804
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 7
DP  - 2023 Jul
TI  - Does Good Nebulization Therapy in the Emergency Room Reduce the Need for 
      Hospitalization in Asthmatic Children?
PG  - e41270
LID - 10.7759/cureus.41270 [doi]
LID - e41270
AB  - INTRODUCTION: Asthma is a chronic inflammatory disorder characterized by 
      obstruction, hyperresponsiveness, and inflammatory changes in the airways. The 
      overall prevalence of asthma in Saudi Arabian children ranges from 8% to 25%. 
      Studies have shown that children who did not respond adequately to treatment in 
      the emergency room (ER) were admitted to hospital for additional treatment which 
      increased the cost and risk of hospital-acquired infections. The quality of 
      nebulization therapy is influenced by several factors such as the position, dose, 
      oxygen flow rate, and duration of treatment.  Objectives: In this study, we aimed 
      to explore factors that affect nebulization therapy in ER and to assess the 
      relation between nebulization technique in ER and hospital admission for 
      asthmatic children, and these aims were achieved over the period from December 
      2021 to May 2023. METHODOLOGY: An observational cross-sectional study was 
      conducted in Maternity and Children Hospital (MCH) in Medina at the ER over the 
      period from December 2021 to May 2023 for all children admitted to ER with asthma 
      exacerbation. The sample size used to include patients in the study is 289 
      calculated using the Openepi website. Data were collected by observation and 
      using medical records of the patients and analyzed using Statistical Package for 
      Social Sciences (SPSS) version 26.0 (IBM Corp., Armonk, NY, USA). RESULTS: The 
      total number of the sample was 289 children ages between two to 14 years. 
      Sixty-four percent (n=185) reported as their gender as male while 36% (n = 104) 
      as female. The median age of the children was four years old (interquartile range 
      [IQR] = 4), and their median weight was 15 kg (IQR = 8.15). Also, more than 83% 
      of the patients has mild asthma, while 16.3% of the sample were diagnosed with 
      moderate to severe asthma. Besides, 92.4% of the sample was discharged from a 
      hospital, and 76.5% received an appropriate dose of nebulization. DISCUSSION: 
      After reviewing the results of the statistical analysis, the main findings were 
      that the severity of asthma exacerbation was the most important factor 
      influencing the outcome. It was found that 0.4% of patients with mild asthma were 
      admitted to the hospital, compared to 44.7% of patients with moderate to severe 
      asthma. CONCLUSION: Our study assessed whether effective nebulization therapy in 
      the ER will reduce the need for hospitalization in asthmatic children and the 
      results indicate that the severity of asthma exacerbation was the most 
      significant factor impacting hospital admission in asthmatic patients and 
      influenced other factors of nebulization therapy. However, the other factors, 
      such as the patient position, oxygen flow rate, and the dose of medications did 
      not show any clinically significant impact on hospitalization rates.
CI  - Copyright (c) 2023, Almazroea et al.
FAU - Almazroea, Abdulhadi H Sr
AU  - Almazroea AH Sr
AD  - Pediatrics, Taibah University, Al-Madinah Al-Munawwarah, SAU.
FAU - Alharbi, Ahmad H
AU  - Alharbi AH
AD  - Pediatric Emergency Medicine, Maternity and Children Hospital in Madinah, 
      Al-Madinah Al-Munawwarah, SAU.
FAU - Alawfi, Bushra A
AU  - Alawfi BA
AD  - Pediatrics, Taibah University, Al-Madinah Al-Munawwarah, SAU.
FAU - Alsaedi, Bushra Q
AU  - Alsaedi BQ
AD  - Pediatrics, Taibah University, Al-Madinah Al-Munawwarah, SAU.
FAU - Samman, Razan S
AU  - Samman RS
AD  - Pediatrics, Taibah University, Al-Madinah Al-Munawwarah, SAU.
FAU - Almohalwas, Maryam A
AU  - Almohalwas MA
AD  - Pediatrics, Taibah University, Al-Madinah Al-Munawwarah, SAU.
LA  - eng
PT  - Journal Article
DEP - 20230702
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10391584
OTO - NOTNLM
OT  - asthma exacerbation
OT  - hospitalization
OT  - nebulization therapy
OT  - oxygen flow rate
OT  - position
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/08/03 06:42
MHDA- 2023/08/03 06:43
PMCR- 2023/07/02
CRDT- 2023/08/03 03:54
PHST- 2023/06/30 00:00 [accepted]
PHST- 2023/08/03 06:43 [medline]
PHST- 2023/08/03 06:42 [pubmed]
PHST- 2023/08/03 03:54 [entrez]
PHST- 2023/07/02 00:00 [pmc-release]
AID - 10.7759/cureus.41270 [doi]
PST - epublish
SO  - Cureus. 2023 Jul 2;15(7):e41270. doi: 10.7759/cureus.41270. eCollection 2023 Jul.