{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T07:03:16Z","timestamp":1779692596241,"version":"3.53.1"},"reference-count":29,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Severe asthma exacerbations remain a major cause of pediatric intensive care unit (PICU) admissions, particularly in early childhood. Objective: To describe the demographic characteristics, clinical features, management strategies, and short-term outcomes of children admitted to the PICU with severe acute asthma exacerbations. Methods: A retrospective descriptive study was conducted of pediatric patients aged 1\u201314 years with severe acute asthma requiring PICU admission at King Salman Medical City, Madinah, Saudi Arabia (January 2023\u2013October 2024). A total of 73 patients were included. Data included demographics, risk factors, medical history, clinical presentation, management, and outcomes. Results: The mean patient age was 4.6 years, with most (57.5%) aged 1\u20135 years. Males comprised 56.2% of cases. WHO BMI-for-age z-score assessment revealed a bimodal nutritional distribution: 27.9% of patients were underweight, including 20.6% with severe underweight, while 29.4% were overweight or obese; 42.6% had normal nutritional status. Severe undernutrition was concentrated in the 1\u20135-year age group, whereas obesity predominated in the 6\u201310-year age group. A family history of asthma was noted in 54.8% of patients; 16.4% had prior COVID-19 infection. Early symptom onset and delayed diagnosis were common. Poor asthma control was documented in 60.3%, with low medication adherence (9.6%) and limited aerochamber use (13.7%). The most frequent presenting symptoms were dyspnea, cough, and wheezing. Management followed evidence-based protocols: systemic corticosteroids and bronchodilators were first-line therapies. The mean PICU stay was 3.1 days and the mean hospital stay was 8.1 days. No mortality or major complications occurred; 93.2% of patients were discharged in good health. Conclusions: Severe pediatric asthma requiring PICU admission is associated with early symptom onset, a bimodal pattern of nutritional risk encompassing both undernutrition and overweight\/obesity, family history of asthma, and inadequate outpatient management. These descriptive findings highlight the need for age-adjusted nutritional screening, enhanced medication adherence support, and targeted outpatient education to reduce avoidable PICU admissions.<\/jats:p>","DOI":"10.3390\/children13050710","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T16:46:18Z","timestamp":1779381978000},"page":"710","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe Asthma Exacerbations in the Pediatric Intensive Care Unit: Clinical Profile, Management, and Outcomes\u2014Retrospective Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3072-2015","authenticated-orcid":false,"given":"Amal H.","family":"Aljohani","sequence":"first","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Pediatric Department, College of Medicine, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3550-5370","authenticated-orcid":false,"given":"Hamdi Ahmed","family":"Alsufiani","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Pediatric Department, King Salman Medical City, Madinah 42319, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer Musaibieh","family":"AlSaadi","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Pediatric Department, King Salman Medical City, Madinah 42319, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora Abdulrahman","family":"Alem","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Pediatric Department, King Salman Medical City, Madinah 42319, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5385-8384","authenticated-orcid":false,"given":"Mamoun","family":"AliAbusunoon","sequence":"additional","affiliation":[{"name":"Clinical Science Department, College of Medicine, Al-Rayan National Colleges, Madinah 42541, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amnah Ibrahim","family":"Madkhali","sequence":"additional","affiliation":[{"name":"Pediatric Department, King Salman Medical City, Madinah 42319, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"248\u2013258","DOI":"10.4187\/respcare.03480248","article-title":"Respiratory emergencies in children","volume":"48","author":"Rotta","year":"2003","journal-title":"Respir. 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