{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T10:34:28Z","timestamp":1774434868670,"version":"3.50.1"},"reference-count":55,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"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":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Volatile anesthetic agents are described as rescue therapy for children invasively ventilated for critical asthma. Yet, data are currently limited to case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>Using the Virtual Pediatric Systems database, we assessed children admitted to a pediatric intensive care unit invasively ventilated for life\u2010threatening asthma and hypothesized ventilation duration and mortality rates would be lower for subjects exposed to volatile anesthetics compared with those without exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a multicenter retrospective cohort study among nine institutions including children 5\u201317\u00a0years of age invasively ventilated for asthma from 2013 to 2019 with and without exposure to volatile anesthetics. Primary outcomes were ventilation duration and mortality. Secondary outcomes included patient characteristics, length of stay, and anesthetic\u2010related adverse events. A subgroup analysis was performed evaluating children intubated \u22652\u00a0days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 203 children included in study, there were 29 (14.3%) with and 174 (85.7%) without exposure to volatiles. No differences in odds of mortality (1.1, 95% CI: 0.3\u20133.9, <jats:italic>p\u00a0<\/jats:italic>&gt;\u00a0.999) were observed. Subjects receiving volatiles experienced greater median difference in length of stay (4.8, 95% CI: 1.9\u20137.8\u00a0days, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a0.001), ventilation duration (2.3, 95% CI: 1\u20133.3\u00a0days, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a0.001), and odds of extracorporeal life support (9.1, 95% CI: 1.9\u201343.2, <jats:italic>p\u00a0<\/jats:italic>=\u00a0.009) than those without volatile exposure. For those ventilated \u22652\u00a0days, no differences were detected in mortality, ventilation duration, length of stay, arrhythmias, or acute renal failure. However, the odds of extracorporeal life support remained greater for those receiving volatiles (7.6, 95% CI: 1.3\u201344.5, <jats:italic>p\u00a0<\/jats:italic>=\u00a0.027). No children experienced malignant hyperthermia or hepatic failure after volatile exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For intubated children for asthma, no differences in mechanical ventilation duration or mortality between those with and without volatile anesthetic exposure were observed. Although volatiles may represent a viable rescue therapy for severe cases of asthma, definitive, and prospective trials are still needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14295","type":"journal-article","created":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T05:56:45Z","timestamp":1631512605000},"page":"1340-1349","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Volatile anesthetic agents for life\u2010threatening pediatric asthma: A multicenter retrospective cohort study and narrative review"],"prefix":"10.1111","volume":"31","author":[{"given":"Alicia","family":"Lew","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of South Florida College of Medicine Tampa FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Morrison","sequence":"additional","affiliation":[{"name":"Departmnet of Pediatrics Johns Hopkins University School of Medicine Johns Hopkins All Children\u2019s Hospital St. Petersburg FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest K.","family":"Amankwah","sequence":"additional","affiliation":[{"name":"Departmnet of Pediatrics Johns Hopkins University School of Medicine Johns Hopkins All Children\u2019s Hospital St. Petersburg FL USA"},{"name":"Department of Oncology Johns Hopkins University School of Medicine Johns Hopkins All Children\u2019s Hospital St. Petersburg FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard A.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Johns Hopkins University School of Medicine Johns Hopkins All Children\u2019s Hospital St. Petersburg FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6290-4975","authenticated-orcid":false,"given":"Anthony A.","family":"Sochet","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of South Florida College of Medicine Tampa FL USA"},{"name":"Department of Anesthesiology and Critical Care Medicine Johns Hopkins University School of Medicine Johns Hopkins All Children\u2019s Hospital St. Petersburg FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,24]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"United States Center for Disease Control and Prevention.Most recent asthma data: national current asthma prevalence 2018. Available at:https:\/\/www.cdc.gov\/asthma\/most_recent_national_asthma_data.htm. Accessed July 6 2020."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-3318"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-2233C"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40733-016-0029-3"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24554"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.02.041"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066617740079"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-1733"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e318238b428"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05174"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2016.10.004"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ddmod.2014.02.004"},{"issue":"3","key":"e_1_2_10_14_1","first-page":"646","article-title":"Epithelial dependence of the bronchodilatory effect of sevoflurane and desflurane in rat distal bronchi","volume":"86","author":"Park KW","year":"1998","journal-title":"Anesth Analg"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199706000-00010"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12577"},{"key":"e_1_2_10_17_1","first-page":"809","article-title":"Resistant status asthmaticus in children","volume":"77","author":"DeNicola LK","year":"1990","journal-title":"J Fla Med Assoc"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.97.3.698"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2004.01260.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200X.1997.tb03758.x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198205000-00013"},{"issue":"4","key":"e_1_2_10_22_1","first-page":"305","article-title":"Isoflurane anesthesia for the treatment of refractory status asthmaticus","volume":"66","author":"Otte RW","year":"1991","journal-title":"Ann Allergy"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000852"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/02770900500264812"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1988.tb06636.x"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.78.4.395a"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0163-0"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066617713169"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.01605"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijccm.IJCCM_191_18"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2008.02503.x"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/00130478-200007000-00011"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-017-0077-0"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199512001-00008"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3182772e29"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e31828a817d"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-8707(39)90472-7"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200408000-00018"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeh049"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2009.10.008"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201504-0763PP"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PCC.0000154946.62733.94"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2013.09.024"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.109.5.1256"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-2136"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000055369.37620.EE"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc7735"},{"issue":"3","key":"e_1_2_10_48_1","first-page":"343","article-title":"Status asthmaticus requiring extracorporeal membrane oxygenation associated with rhinovirus infection","volume":"57","author":"Lauren G","year":"2019","journal-title":"J Asthma"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24616"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24751"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199406000-00024"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1973.03220410023005"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-197704000-00007"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181f4db38"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.3109\/02770903.2014.971969"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200203000-00015"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14295","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pan.14295","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14295","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T13:34:48Z","timestamp":1693229688000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.14295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,24]]},"references-count":55,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1111\/pan.14295"],"URL":"https:\/\/doi.org\/10.1111\/pan.14295","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,24]]},"assertion":[{"value":"2021-02-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}