345 HOSPITAL CARE Review of Intensive Care Unit Admissions for Asthma Warren Richards, M.D., Cheryl Lew, M.D., Jean Carney, M.D., Arnold Platzker, M.D., Joseph A. Church, M.D. Correspondence to: Warren Richards, M.D., Head, Division of Allergy, Childrens Hospital of Los Angeles, University of Southern California School of Medicine, 4650 Sunset Boulevard, Los Angeles, CA 90027. A review of ICU admissions for asthma to the Childrens Hospital of Los Angeles was conducted for the period January 1969 through July 1977. The admission rate remained relatively constant during this period. Patients requiring ICU admission tended to be young, intractable severe asthmatics whose asthma started at a very young age. There were three patients who had no previous history of asthma. The incidence of pneumomitis/atelectasis was somewhat greater than has been reported for patients hospitalized for status asthmaticus. A significant number of children received neither intravenous corticosteroids, sympathomimetics nor oxygen therapy while hospitalized prior to transfer to the ICU. Those children receiving mechanical ventilation or intravenous isoproterenol tended to be somewhat younger and had a higher incidence of pneumonitis/atelectasis and more abnormal blood gas determina- tions than their counterparts who were not similarly treated. Mechanical ventilation was administered to 15 patients and 19 patients received intra- venous isoproterenol. Intravenous isoproterenol resulted in prompt improve- ment in most patients; except for one patient who experienced cardiac arrhyth- mia (reversed when the dosage was decreased), this medication was well-tolerated. NEWER METHODS of therapy for asthma such as high-dose theophylline therapy, beta- two adrenergic agents, cromolyn sodium and steroid aerosols have allowed better control of severe asthma than achieved in the past. However, despite these advances, acute asthma may still be life-threatening. The of this investigation were to determine the gen- eral clinical of patients admitted to the care (!CU) of Childre-r,,’s Hospital of Los Angeles (CHLA) between January 1969, and July ~97’~~ the presence of possible factors predisposing to their admis- sion, the existence of any trends in the ICU admission rate, and the examination of the results of therapy given to these patients. Methods The medical records of all patients with the of status astlimaticus admitted to the ICU from January 1969, through July 1977, were studied. The medical record of one child who was transferred to the ICU after a cardiac arrest at another hospital was excluded. The information recorded ir~~~~s~~~ age of onset of asthma, assessment as to whether the pa- tient had sporadic attacks (less frequent than once weekly) or intractable asthmatic course,