Abstract Background Near-fatal asthma represents the most severe clinical presentation of asthma and remains a leading cause of admission to pediatric intensive care units (PICUs) worldwide. In Colombia, data on its epidemiological and clinical characteristics in children are extremely limited. Understanding these patterns is crucial for developing prevention and management strategies that could reduce morbidity and mortality. Objective To describe the sociodemographic, clinical, and paraclinical characteristics of children and adolescents with near-fatal asthma admitted to the PICU of the Fundación Hospital de la Misericordia (HOMI) in Bogotá, Colombia, between 2022 and 2024. Methods A retrospective descriptive study was conducted by reviewing medical records of patients aged 5-17 years diagnosed with asthma who required ventilatory support during admission to the PICU. Variables included demographic data, comorbidities, exposure to environmental risk factors, radiological and laboratory findings, and respiratory pathogens identified by viral panels. Qualitative variables were analyzed through proportions, while quantitative variables were expressed as medians and interquartile ranges. Results A total of 125 patients met the inclusion criteria. The median age was 7 years (IQR 4), with a slight female predominance (53.6%). The most frequent risk factors were exposure to pets (34.4%), tobacco smoke (17.6%), allergic rhinitis (33.6%), and a family history of asthma (31.2%). Only 18.4% were receiving controller therapy at admission. Nutritional status was adequate in 52% of cases, and obesity was observed in 3.2%. The median length of PICU stay was 3 days, with a median of 1 day of oxygen support, predominantly via high-flow nasal cannula (81.6%). Only one patient required invasive mechanical ventilation. Radiographic findings most frequently included bronchial thickening (40.8%) and atelectasis (30.4%). Of 90 respiratory viral panels performed, 94% were positive, with Rhinovirus/Enterovirus (78.9%) being the main etiologic agent, followed by Adenovirus (11.2%) and Mycoplasma pneumoniae (8.9%). Conclusions Near-fatal asthma continues to have a significant impact on pediatric morbidity in Colombia. The predominance of viral triggers, particularly Rhinovirus, and the high frequency of modifiable environmental exposures highlight the need for targeted preventive interventions. Early identification of at-risk patients, promotion of treatment adherence, and environmental control could reduce severe exacerbations and PICU admissions. This study provides the first local characterization of near-fatal asthma in Colombian children and underscores the importance of further research to establish tailored management and prevention strategies This abstract is funded by: not
Osorio et al. (Fri,) studied this question.