[Management of severe acute asthma in children in pediatric urgent and intensive care units]

Area of Science:

• Pediatric Emergency Medicine
• Respiratory Medicine
• Critical Care

Context:

• Severe asthma attacks in children are a significant cause of pediatric emergency department visits.
• Mortality associated with severe pediatric asthma attacks is approximately 1%.

Purpose:

• To outline the therapeutic management of severe asthma attacks in children.
• To guide clinical decision-making during emergency and intensive care settings.
• To emphasize relapse prevention strategies.

Summary:

• Initial management focuses on clinical and paraclinical severity criteria, including oxygen therapy, inhaled bronchodilators, and systemic corticosteroids.
• Treatment decisions (outpatient, continued hospitalization, or intensive care transfer) are based on patient response.
• Intensive care involves continuous intravenous beta-2 agonists, aiming to avoid mechanical ventilation, with controlled hypoventilation if ventilation is necessary.
• Post-intensive care, hospitalization in a specialized unit is recommended for relapse prevention.

Impact:

• Provides a framework for standardized emergency care of severe pediatric asthma.
• Highlights the importance of continuous monitoring and timely intervention.
• Aims to reduce morbidity and mortality associated with severe asthma exacerbations in children.