دورية أكاديمية
أعرض في EDS

Screening for sleep disordered breathing among children hospitalized for asthma exacerbation.

التفاصيل البيبلوغرافية
العنوان: Screening for sleep disordered breathing among children hospitalized for asthma exacerbation.
المؤلفون: Gurbani N; Cincinnati Children's Hospital Medical Center, Division of Pulmonary Medicine, Cincinnati, Ohio, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Schuler CL; Cincinnati Children's Hospital Medical Center, Division of Pulmonary Medicine, Cincinnati, Ohio, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.; Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, Cincinnati, Ohio, USA., Ignatiuk D; Cincinnati Children's Hospital Medical Center, Division of Pulmonary Medicine, Cincinnati, Ohio, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Albrecht J; Cincinnati Children's Hospital Medical Center, Division of Quality Improvement Systems, Cincinnati, Ohio, USA., Guo Y; Cincinnati Children's Hospital Medical Center, Division of Pulmonary Medicine, Cincinnati, Ohio, USA., Waits A; Cincinnati Children's Hospital Medical Center, Division of Respiratory Care, Cincinnati, Ohio, USA., Kercsmar CM; Cincinnati Children's Hospital Medical Center, Division of Pulmonary Medicine, Cincinnati, Ohio, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
المصدر: Pediatric pulmonology [Pediatr Pulmonol] 2023 Dec; Vol. 58 (12), pp. 3458-3465. Date of Electronic Publication: 2023 Sep 13.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley-Liss Country of Publication: United States NLM ID: 8510590 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1099-0496 (Electronic) Linking ISSN: 10990496 NLM ISO Abbreviation: Pediatr Pulmonol Subsets: MEDLINE
أسماء مطبوعة: Publication: <2005-> : Hoboken, NJ : Wiley-Liss
Original Publication: [Philadelphia, PA] : W.B. Saunders, [c1985-
مواضيع طبية MeSH: Sleep Apnea Syndromes*/complications , Sleep Apnea Syndromes*/diagnosis , Sleep Apnea Syndromes*/epidemiology , Asthma*/complications , Asthma*/diagnosis , Asthma*/epidemiology, Child ; Humans ; Sleep ; Comorbidity ; Surveys and Questionnaires
مستخلص: Background: Sleep disordered breathing (SDB) may exacerbate asthma and is a treatable comorbidity.
Objective: To design and implement a screening process for SDB in patients hospitalized for asthma exacerbation using quality improvement (QI) methods. We sought to improve screening for SDB from zero to 60% from July 2019 to December 2020.
Design/methods: A multidisciplinary team used QI methods to screen for SDB using the Michigan pediatric sleep questionnaire (PSQ) in patients 2-18 years hospitalized for asthma exacerbation. Key interventions included: pairing the PSQ screen with another element of routine care (the asthma risk factor screen), educating staff and physicians, engaging respiratory therapists to complete the PSQ and document scores, and modifying the electronic medical record (asthma order set and flowsheet for PSQ score documentation). A run chart tracked progress and descriptive statistics were generated.
Results: There were 2067 patients admitted for asthma exacerbation during this project. The PSQ was completed for 1531 patients (74%) overall. Of screened patients, 360 (24%) had a positive PSQ; the mean age was 8.6 years. Approximately 14 months after the project began, ~90% of children admitted for asthma were being screened; subsequently, >80% of patients were being screened until May 2022. Screening with the PSQ occurred approximately 90% of the time when routine asthma risk screens were completed.
Conclusion: A screening process for SDB was successfully implemented and appeared feasible and sustainable. The high proportion of positive screens reinforces the importance of evaluating for SDB in the high-risk population of children requiring hospitalization for asthma exacerbation.
(© 2023 Wiley Periodicals LLC.)
References: Pate CA, Zahran HS, Qin X, Johnson C, Hummelman E, Malilay J. Asthma surveillance-United States, 2006-2018. MMWR. Surveillance Summaries. 2021;70(5):1-32.
Perry R, Braileanu G, Palmer T, Stevens P. The economic burden of pediatric asthma in the United States: literature review of current evidence. Pharmacoeconomics. 2019;37(2):155-167.
Zahran HS, Bailey CM, Damon SA, Garbe PL, Breysse PN. Vital signs: asthma in children-United States, 2001-2016. MMWR Morb Mortal Wkly Rep. 2018;67(5):149-155.
Hogan AH, Carroll CL, Iverson MG, et al. Risk factors for pediatric asthma readmissions: a systematic review. J Pediatr. 2021;236:219-228.
Lowden R, Turner S. Past asthma exacerbation in children predicting future exacerbation: a systematic review. ERJ Open Res. 2022;8(4):00174.
Prasad B, Nyenhuis SM, Imayama I, Siddiqi A, Teodorescu M. Asthma and obstructive sleep apnea overlap: what has the evidence taught us? Am J Respir Crit Care Med. 2020;201(11):1345-1357.
Prasad B, Nyenhuis SM, Weaver TE. Obstructive sleep apnea and asthma: associations and treatment implications. Sleep Med Rev. 2014;18(2):165-171.
Ross KR, Storfer-Isser A, Hart MA, et al. Sleep-disordered breathing is associated with asthma severity in children. J Pediatr. 2012;160(5):736-742.
Tsou PY, Cielo C, Xanthopoulos MS, Wang YH, Kuo PL, Tapia IE. Impact of obstructive sleep apnea on assisted ventilation in children with asthma exacerbation. Pediatr Pulmonol. 2021;56(5):1103-1113.
Dooley AA, Jackson JH, Gatti ML, et al. Pediatric sleep questionnaire predicts more severe sleep apnea in children with uncontrolled asthma. J Asthma. 2021;58(12):1589-1596.
Fueyo GO. Chronic rhinitis treatment: effects on obstructive sleep apnea. Curr Treatment Opt Allergy. 2022;9(3):292-301.
Marcus CL, Brooks LJ, Ward SD, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012;130(3):e714-e755.
Sanchez T, Castro-Rodriguez JA, Brockmann PE. Sleep-disordered breathing in children with asthma: a systematic review on the impact of treatment. J Asthma Allergy. 2016;9:83-91.
Mitchell H, Senturia Y, Gergen P, et al. Design and methods of the National Cooperative Inner-City Asthma Study. Pediatr Pulmonol. 1997;24(4):237-252.
Kercsmar CM, Beck AF, Sauers-Ford H, et al. Association of an asthma improvement collaborative with health care utilization in medicaid-insured pediatric patients in an urban community. JAMA Pediatr. 2017;171(11):1072-1080.
Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med. 2000;1(1):21-32.
Ehsan Z, Kercsmar CM, Collins J, Simakajornboon N. Validation of the pediatric sleep questionnaire in children with asthma. Pediatr Pulmonol. 2017;52(3):382-389.
Kheirandish-Gozal L, Dayyat EA, Eid NS, Morton RL, Gozal D. Obstructive sleep apnea in poorly controlled asthmatic children: effect of adenotonsillectomy. Pediatr Pulmonol. 2011;46(9):913-918.
Ferry AM, Wright AE, Ohlstein JF, Khoo K, Pine HS. Efficacy of a pediatric sleep questionnaire for the diagnosis of obstructive sleep apnea in children. Cureus. 2020;12(12):e12244.
Goldstein NA, Aronin C, Kantrowitz B, et al. The prevalence of sleep-disordered breathing in children with asthma and its behavioral effects. Pediatr Pulmonol. 2015;50(11):1128-1136.
Ginis T, Akcan FA, Capanoglu M, et al. The frequency of sleep-disordered breathing in children with asthma and its effects on asthma control. J Asthma. 2017;54(4):403-410.
Carroll JL, McColley SA, Marcus CL, Curtis S, Loughlin GM. Inability of clinical history to distinguish primary snoring from obstructive sleep apnea syndrome in children. Chest. 1995;108(3):610-618.
Gozal D, Ismail M, Brockmann PE. Alternatives to surgery in children with mild OSA. World J Otorhinolaryngol-Head Neck Surg. 2021;7(3):228-235.
Rana M, August J, Levi J, Parsi G, Motro M, DeBassio W. Alternative approaches to adenotonsillectomy and continuous positive airway pressure (CPAP) for the management of pediatric obstructive sleep apnea (OSA): a review. Sleep Disord. 2020;2020:1-11.
معلومات مُعتمدة: Cincinnati Children's Hospital Research Fund
فهرسة مساهمة: Keywords: child; snoring; wheezing
تواريخ الأحداث: Date Created: 20230913 Date Completed: 20231122 Latest Revision: 20231122
رمز التحديث: 20231122
DOI: 10.1002/ppul.26676
PMID: 37701984
قاعدة البيانات: MEDLINE
الوصف
تدمد:1099-0496
DOI:10.1002/ppul.26676