{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:19:20Z","timestamp":1790011160826,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pediatric asthma exacerbations sometimes require aggressive intervention including continuous albuterol, a cornerstone therapy for reversing airway obstruction. However, pediatric dosing typically follows adult guidelines, with limited evidence for specific dosing ranges. This study aimed to compare the clinical outcomes of a reduced initial dose (10\u2009mg\/h) of continuous albuterol with a standard dose (15\u2009mg\/h) in children hospitalized for critical asthma exacerbations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study was conducted at Riley Hospital for Children, analyzing pediatric patients (ages: 2\u201318) admitted with critical asthma exacerbations between 2014 and 2022. Stabilized inverse probability weighting (SIPW) was used to adjust for confounding factors between groups. The primary outcome was the percentage change in the Pediatric Asthma Severity Score (PASS) at 24\u2009h, with secondary outcomes including the duration of continuous albuterol, PICU length of stay, and hospital length of stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Analysis of 1,486 encounters revealed no significant difference in percent PASS changes at 24\u2009h between the 10\u2009mg\/h and 15\u2009mg\/h groups (Additive Treatment Effect of 1.69, 95% CI: \u22120.93\u20134.31,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.207). PICU and hospital lengths of stay were also similar. However, the 10\u2009mg\/h group showed a significantly shorter duration of continuous albuterol therapy compared to the 15\u2009mg\/h group (Multiplicative Treatment Effect of 1.29, 95% CI: 1.14\u20131.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings suggest that starting continuous albuterol at 10\u2009mg\/h provides clinical outcomes comparable to 15\u2009mg\/h in managing pediatric critical asthma exacerbations. A lower starting dose may optimize resource use and reduce treatment\u2010related adverse effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71293","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T10:37:27Z","timestamp":1757587047000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Estimating the Effects of Continuous Albuterol Dosage on Clinical Outcomes for Pediatric Critical Asthma Exacerbation: A Retrospective Cohort Study"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6240-6212","authenticated-orcid":false,"given":"Daniel P.","family":"Riggins","sequence":"first","affiliation":[{"name":"Center for Biomedical Informatics Regenstrief Institute Indianapolis Indiana USA"},{"name":"Department of Epidemiology, Fairbanks School of Public Health Indiana University Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eneida A.","family":"Mendonca","sequence":"additional","affiliation":[{"name":"Division of Biomedical Informatics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics, College of Medicine University of Cincinnati Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Bulgarelli","sequence":"additional","affiliation":[{"name":"Division of Biomedical Informatics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Tachinardi","sequence":"additional","affiliation":[{"name":"Division of Biomedical Informatics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanzhu","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics &amp; Health Data Sciences, School of Medicine Indiana University Indianapolis Indiana USA"},{"name":"Indiana University Center for Aging Research Regenstrief Institute Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5251-2399","authenticated-orcid":false,"given":"Colin","family":"Rogerson","sequence":"additional","affiliation":[{"name":"Center for Biomedical Informatics Regenstrief Institute Indianapolis Indiana USA"},{"name":"Department of Pediatrics Indiana University School of Medicine Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/pir.2018-0282"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.Cd001115"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1124\/pr.111.004580"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.110.1.42"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/pcc.0000000000000314"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/02770903.2020.1723622"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.101.2.305"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2012.674587"},{"key":"e_1_2_9_10_1","unstructured":"G.Heiman \u201cCreating a New Supply Chain for Continuous Albuterol \u201d Children's Hospital Association accessed May 2024 https:\/\/www.childrenshospitals.org\/news\/childrens-hospitals-today\/2023\/02\/creating-a-new-supply-chain-for-continuous-albuterol."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(07)61602-x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7594"},{"key":"e_1_2_9_13_1","unstructured":"R: A Language and Environment for Statistical Computing. 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