Effects of airway clearance in hospitalized children with neurologic impairment
Airway clearance therapies (ACT) are often used to optimize respiratory function for children with neurologic impairment (CNI) hospitalized with acute respiratory infections (ARI). In a five-center retrospective cohort study of CNI aged 1-18 years hospitalized between 2013 and 2015 with ARI, we assessed the association of admission ACT with hospital outcomes (days to return to baseline respiratory support and length of stay [LOS]). Generalized estimated equation (GEE) models examined the association between ACT and outcomes, while accounting for clustering. Propensity scores estimating the likelihood of receiving ACT were included in the GEE models as inverse probability of treatment weights to account for confounding. In adjusted analyses, children receiving admission ACT required similar time to return to respiratory baseline (adjusted risk ratio [aRR] 1.24, 95%CI: 0.95,1.62) and had similar LOS (aRR 1.08, 95%CI: 0.88,1.32) compared with children not receiving ACT. Future studies should seek to identify subpopulations of CNI who benefit most from ACT.
Authors
- Rebecca Steuart (ORCID: https://orcid.org/0000-0002-5973-475X)
- Amanda Warniment (ORCID: https://orcid.org/0009-0000-0998-7014)
- Samir S. Shah (ORCID: https://orcid.org/0000-0001-7902-7000)
- Joanna E. Thomson (ORCID: https://orcid.org/0000-0002-7538-0998)
- Jay G. Berry (ORCID: https://orcid.org/0000-0003-3917-4465)
- Elise Peterson Lu (ORCID: https://orcid.org/0009-0000-8998-9895)
- Matt Hall (ORCID: https://orcid.org/0000-0001-7778-5887)
- Emilie Korn
- Elena Griego (ORCID: https://orcid.org/0000-0001-5728-0080)
- Tony Tarchichi
- Chris Bonafide
- Tamara D. Simon (ORCID: https://orcid.org/0000-0003-4734-7020)
Institutions
- Cincinnati Children's Hospital Medical Center (US)
- Boston Children's Hospital (US)
- Seattle Children's Hospital (US)
- Children's Hospital of Philadelphia (US)
- Harvard University (US)
- University of Pittsburgh (US)
- University of Washington (US)
- Children's Hospital of Pittsburgh (US)
- Children's Hospital Association (US)
- University of Pennsylvania (US)
- University of Cincinnati Medical Center (US)
Publication Details
- Journal
- Journal of Hospital Medicine
- Published
- 2024-10-28
- DOI
- https://doi.org/10.1002/jhm.13543
- Citations
- 2
- Primary Topic
- Emergency and Acute Care Studies
- Type
- article
- Field-Weighted Citation Impact
- 1.38
Funders
- Agency for Healthcare Research and Quality
- National Center for Advancing Translational Sciences