{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:16:44Z","timestamp":1777853804503,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systemic corticosteroids are vital to critical asthma management. While intravenous methylprednisolone is routinely used in the pediatric intensive care unit (PICU) setting, recent data supports dexamethasone as an alternative. Using the Pediatric Health Information System (PHIS) registry, we assessed trends and variation in corticosteroid prescribing among children hospitalized for critical asthma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a multicenter retrospective cohort study using PHIS data among children 3-17 years of age admitted for critical asthma from 2011 through 2019. Primary outcomes were corticosteroid prescribing rates by year and participating sites. Exploratory outcomes were corticosteroid-related adverse effects, rates of adjunctive pharmaceutical and respiratory interventions, mortality and length of stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 49 children's hospitals assessed, 26\u2005907 encounters were included for study. Mean dexamethasone exposure rates were 18.1\u2009\u00b1\u20092.4% where 2.4\u2009\u00b1\u20091.2% represented dexamethasone-alone prescribing. Dexamethasone alone prescribing exhibited a linear trend (annual increase of 0.5\u2009\u00b1\u20090.1% annually R\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.845) without correlation to cumulative site critical asthma admission rates. Compared to encounters prescribed solely methylprednisolone or a combination of dexamethasone and methylprednisolone, subjects provided dexamethasone alone had reduced asthma severity indices, length of stay, and exposure rates to adjunctive asthma interventions. Adverse events were rare and the dexamethasone-alone group less frequently experienced gastritis and hyperglycemia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this multicenter retrospective study from 49 children's hospitals, dexamethasone prescribing rates appear increasing for pediatric critical asthma. Observed variability in corticosteroid prescribing implies a continued need for controlled prospective comparative analyses to define ideal corticosteroid regimens for pediatric critical asthma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666221082540","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T03:19:40Z","timestamp":1646277580000},"page":"1520-1527","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Dexamethasone for Pediatric Critical Asthma: A Multicenter Descriptive Study"],"prefix":"10.1177","volume":"37","author":[{"given":"Austin R.","family":"Sellers","sequence":"first","affiliation":[{"name":"Institute for Clinical and Translational Research, Johns Hopkins All Children\u2019s Hospital, St. Petersburg, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan R.","family":"Roddy","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Johns Hopkins All Children\u2019s Hospital, St. Petersburg, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina K.","family":"Darville","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pediatric Critical Care Medicine, Johns Hopkins All Children\u2019s Hospital, St. Petersburg, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Sanchez-Teppa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pediatric Critical Care Medicine, Johns Hopkins All Children\u2019s Hospital, St. Petersburg, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott D.","family":"McKinley","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pediatric Pulmonology and Sleep 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":"Institute for Clinical and Translational Research, Johns Hopkins All Children\u2019s Hospital, St. Petersburg, FL, USA"},{"name":"Department of Medicine, Division of Pediatric Critical Care Medicine, Johns Hopkins All Children\u2019s Hospital, St. Petersburg, FL, USA"},{"name":"Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,3,3]]},"reference":[{"key":"bibr1-08850666221082540","unstructured":"United States Centers for Disease Control and Prevention. 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