{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T06:04:22Z","timestamp":1775628262379,"version":"3.50.1"},"reference-count":22,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T00:00:00Z","timestamp":1552953600000},"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":["Respir Care"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Status asthmaticus is one of the most frequent admission diagnoses in the pediatric ICU (PICU). Collaboration between respiratory therapists (RTs) and physicians may help efficiently deliver care to a patient in status asthmaticus. The Pediatric Asthma Severity Score (PASS) is a measure of severity of a patient's asthma exacerbation at a point in time. The aim of this quality improvement initiative was to establish an RT-driven continuous albuterol weaning protocol using the PASS score. We hypothesized that this would decrease the duration of continuous albuterol without increasing adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This was a single-center implementation study in the PICU of a quaternary care children's hospital. Patients with a diagnosis of status asthmaticus who met criteria on continuous albuterol between September 2015 and September 2017 were included. An interdisciplinary team established the protocol, order sets, documentation, and education for involved staff. Qualifying subjects were assessed by an RT per protocol and assigned a PASS score, and the albuterol dose was adjusted on the basis of the PASS score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      We compared 104 subjects studied before the implementation of this protocol (September 2015 to August 2016) to 117 subjects after the implementation of this protocol (September 2016 to October 2017). Median (interquartile range) duration of continuous albuterol in the PICU post-implementation was unchanged compared to pre-implementation: 12.1 (7.2\u201321.0) h versus 11.1 (6\u201319) h (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .22). Median PICU length of stay was also unchanged post-implementation compared to pre-implementation: 19.5 (14.3\u201329.7) h versus 23.2 (15.2\u201331.3) h (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .16). Using control charts, these processes were stable. There was no difference in adverse events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>An interprofessionally-developed, RT-driven continuous albuterol weaning protocol can be implemented without negatively impacting duration of continuous albuterol or PICU length of stay and without increasing adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.06447","type":"journal-article","created":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T10:23:05Z","timestamp":1552990985000},"page":"1358-1365","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Implementing a Respiratory Therapist-Driven Continuous Albuterol Weaning Protocol in the Pediatric ICU"],"prefix":"10.1177","volume":"64","author":[{"given":"Danielle K","family":"Maue","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care Medicine, Indiana University School of Medicine\/Riley Hospital for Children at IU Health, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvaro J","family":"Tori","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care Medicine, Indiana University School of Medicine\/Riley Hospital for Children at IU Health, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew L","family":"Beardsley","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care Medicine, Indiana University School of Medicine\/Riley Hospital for Children at IU Health, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia L","family":"Krupp","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pulmonology, Indiana University School of Medicine\/Riley Hospital for Children at IU Health, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Acrista J","family":"Hole","sequence":"additional","affiliation":[{"name":"Department of Respiratory Care Services, Riley Hospital for Children at Indiana University Health, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth AS","family":"Moser","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Indiana University, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney M","family":"Rowan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care Medicine, Indiana University School of Medicine\/Riley Hospital for Children at IU Health, Indianapolis, IN."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,3,19]]},"reference":[{"issue":"08","key":"e_1_3_2_2_2","first-page":"1","article-title":"National Surveillance for Asthma\u2013United States, 1980-2004","volume":"56","author":"Centers for Disease Control and Prevention","year":"2007","unstructured":"Centers for Disease Control and Prevention. National Surveillance for Asthma\u2013United States, 1980-2004. MMWR Surv Summ, 2007; 56(SS08);1\u201314; 18\u201354.","journal-title":"MMWR Surv Summ"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.4172\/2161-0665.1000217"},{"key":"e_1_3_2_4_2","unstructured":"Children's Health Care of Colorado Asthma Clinical Care Guidelines. Available at: https:\/\/www.ihconline.org\/media\/cms\/Childrens_Hospital_Colorado_asthmac_147F03BB6763A.pdf. Accessed February 15 2019."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e31818c268f"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2003.07.015"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.5409\/wjcp.v6.i1.34"},{"issue":"4","key":"e_1_3_2_8_2","first-page":"369","article-title":"The current role of intravenous aminophylline in acute paediatric asthma","volume":"55","author":"Mitra A","year":"2003","unstructured":"Mitra A. The current role of intravenous aminophylline in acute paediatric asthma. Minerva Pediatr, 2003; 55(4):369\u2013375.","journal-title":"Minerva Pediatr"},{"issue":"3","key":"e_1_3_2_9_2","first-page":"CD006632","article-title":"Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs","volume":"17","author":"Rotter T","year":"2010","unstructured":"Rotter T, , Kinsman L, , James E, , Machotta A, , Willis J, , Snow P, , Kugler J. Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs. Cochrane Database Syst Rev, 2010; 17(3):CD006632.","journal-title":"Cochrane Database Syst Rev"},{"issue":"9","key":"e_1_3_2_10_2","first-page":"14","article-title":"Consistent high performers. Truven 100 Top Hospitals focus on standardization to improve outcomes and reduce costs","volume":"45","author":"Rice S","year":"2015","unstructured":"Rice S. Consistent high performers. Truven 100 Top Hospitals focus on standardization to improve outcomes and reduce costs. Mod Healthcare, 2015; 45(9):14\u201319.","journal-title":"Mod Healthcare"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.2.9805120"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181872833"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/002013240104600803"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2016-0087"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2005.06.007"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5151.134153"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc1019"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05893"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2013.09.024"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05174"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.16.1987"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.3713"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.06447","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.06447","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.06447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:25:23Z","timestamp":1775625923000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.06447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,19]]},"references-count":22,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.4187\/respcare.06447"],"URL":"https:\/\/doi.org\/10.4187\/respcare.06447","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2019,3,19]]}}}