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Status asthmaticus in children: a review
1Division of Critical Care, University of Kentucky Children's Hospital, Lexington, KY 40536, USA. hwerner@pop.uky.edu
Chest
|June 16, 2001
Summary
Pediatric asthma, a growing concern, involves inflammation and airway narrowing. Aggressive treatment is crucial, with mechanical ventilation reserved for severe cases and managed cautiously to avoid complications.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
Background:
- Pediatric asthma affects approximately 10% of American children.
- Increasing prevalence, morbidity, and mortality rates highlight the severity of childhood asthma.
- Asthma is characterized by airway inflammation, edema, bronchial constriction, and mucous plugging.
Purpose of the Study:
- To outline the aggressive treatment strategies for status asthmaticus in children.
- To discuss the risks and management of mechanical ventilation in pediatric severe asthma.
- To explore unusual and nonestablished therapies for severe asthma cases.
Main Methods:
- Review of current treatment protocols for pediatric status asthmaticus.
- Analysis of the physiological impact of positive-pressure ventilation in dynamic hyperinflation.
- Discussion of alternative and emerging therapeutic approaches.
Main Results:
- Status asthmaticus necessitates aggressive treatment with beta-agonists, anticholinergics, and corticosteroids.
- Positive-pressure ventilation can exacerbate dynamic hyperinflation in intubated children.
- Controlled hypoventilation with low tidal volume and extended expiratory time may mitigate risks like barotrauma and hypotension during mechanical ventilation.
Conclusions:
- Early and aggressive medical management is key for pediatric asthma.
- Mechanical ventilation in pediatric asthma carries significant risks and requires careful consideration.
- Further research into novel therapies for severe pediatric asthma is warranted.