Collaborative management model combined with inhaled corticosteroids in CPAP treatment of acute exacerbations of pediatric bronchial asthma: A retrospective cohort study

Background: Continuous positive airway pressure (CPAP) for treating acute pediatric bronchial asthma exacerbations rises yearly. Inhaled corticosteroids (ICS) are key for controlling asthma-related inflammation, but research on ICS combined with the collaborative management model (CMM) remains incomplete. Objectives: This study aims to explore the effect of CMM combined with ICS in CPAP treatment for children with acute bronchial asthma exacerbations. Methods: 107 children with acute bronchial asthma exacerbations receiving CPAP in our hospital’s Respiratory Department (Jan 2023-Jan 2025) were screened; 104 were included after exclusions. Based on the records of medical record treatment, they were divided into ICS group (51 cases) and CMM+ICS group (combined group, 53 cases). Primary outcomes: pulmonary function [forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF)], arterial blood gas [Arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), oxygen saturation (SaO2)] and CPAP-related complication incidence. Secondary outcomes: vital signs [respiratory rate (RR), heart rate (HR), blood pressure (BP)], hospital stay length, duration of a single management session, incremental cost-effectiveness ratio (ICER), pediatric asthma quality of life questionnaire (PAQLQ) scores and parental self-rating anxiety scale (SAS) anxiety levels. Results: Results showed that the combined group had significantly higher FEV1, PEF, PaO2 and SaO2 than the ICS group (all p<0.05), whereas PaCO2 (p<0.001) and CPAP complication incidence (p=0.024) were lower than the ICS group. Additionally, the combined group had significantly lower RR, HR, SBP and DBP (all p<0.05), significantly shorter hospital stay and duration of a single management session (both p<0.001) and a significantly favorable ICER (-225.13 yuan/day) than the ICS group. Moreover, it had significantly higher PAQLQ scores (p<0.001) and lower parental SAS scores (p<0.001) compared with the ICS group. Conclusion: CMM combined with ICS in CPAP improves pediatric acute asthma exacerbations, has high clinical value, worthy of respiratory promotion.