{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T08:40:22Z","timestamp":1756543222676,"version":"3.44.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To describe the characteristics, management, and outcomes of a paediatric cohort with severe acute asthma or wheeze retrieved to tertiary care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study of children \u2265\u20091\u2009year old with severe acute asthma or wheeze retrieved to tertiary paediatric centres by a statewide paediatric retrieval service, January 2017 to May 2023. Data of clinical characteristics, pharmacotherapy, respiratory support, and outcomes were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 325 patients, median age 6.8\u2009years (IQR 3.8\u201310.5) and 61% male. High rates of nebulised bronchodilators, systemic corticosteroids, intravenous magnesium sulphate, and adjunct aminophylline use were observed. Ketamine was the preferred sedative agent among cases managed with mechanical or non\u2010invasive ventilation. Intravenous salbutamol use declined significantly during the study (<jats:italic>p<\/jats:italic>\u2009=\u20090.04). Intubation rates were low (6.8%), non\u2010invasive ventilation was the most common respiratory support (37.2%), and high\u2010flow nasal cannula use increased over the study (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Overall, 65.5% of patients were admitted to intensive care. We report two deaths (0.9%) following intensive care admission and infrequent complications, including air leak (2.2%) and haemodynamic instability (2.8%). Variables associated with intensive care admission include pre\u2010existing asthma diagnosis, preventer prescription, and previous intensive care admission (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Contemporary severe acute asthma management frequently includes adjunct aminophylline and non\u2010invasive ventilation. Clinical outcomes were overall good with short intensive care and hospital stays, low mortality rates, and infrequent complications. Children with pre\u2010existing asthma diagnosis, preventer prescription, or prior PICU admission for asthma were more likely to require PICU care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.70101","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T06:39:11Z","timestamp":1749105551000},"page":"1256-1262","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics and Outcomes of Paediatric Patients With\u00a0Severe Acute Asthma in Retrieval"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4243-3202","authenticated-orcid":false,"given":"Kuangjun","family":"Li","sequence":"first","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service  Sydney New South Wales Australia"},{"name":"Kids Research, The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily R.","family":"Le Fevre","sequence":"additional","affiliation":[{"name":"Kids Research, The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffany","family":"Pizzuto","sequence":"additional","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marino","family":"Festa","sequence":"additional","affiliation":[{"name":"Kids Research, The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Haggie","sequence":"additional","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service  Sydney New South Wales Australia"},{"name":"Faculty of Medicine, University of Wollongong  Wollongong Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"volume-title":"Australia's Children","year":"2020","author":"Australian Institute of Health and Welfare","key":"e_1_2_10_2_1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.5863\/1551-6776-18.2.88"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.008914"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.05.001"},{"volume-title":"Asthma\u2014Acute Management","year":"2023","author":"The Sydney Children's Hospitals Network","key":"e_1_2_10_6_1"},{"issue":"4","key":"e_1_2_10_7_1","first-page":"307","article-title":"Paediatric Acute Asthma Management in Australia and New Zealand: Practice Patterns in the Context of Clinical Practice Guidelines","volume":"93","author":"Babl F. 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