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Evidence-based treatments for acute asthma
B H Rowe1, M L Edmonds, C H Spooner
1Division of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada. brian.rowe@ualberta.ca
Respiratory Care
|December 1, 2001
Summary
Effective acute asthma treatment involves beta agonists and systemic corticosteroids. Adding ipratropium bromide or intravenous magnesium sulfate may benefit severe asthma cases, while antibiotics and aminophylline are not recommended for acute asthma management.
Area of Science:
- Pulmonology
- Emergency Medicine
- Clinical Therapeutics
Background:
- Asthma affects over 12 million Americans, with millions of emergency department visits annually.
- Acute asthma presentations are common, particularly in young patients, and often indicate severe disease.
- Controlling asthma is crucial for patient well-being and reducing healthcare burdens.
Purpose of the Study:
- To review evidence-based therapies for acute asthma.
- To guide treatment decisions using high-level evidence from systematic reviews and randomized controlled trials.
- To identify effective and ineffective acute asthma treatments.
Main Methods:
- Systematic reviews, particularly from the Cochrane Collaboration, were prioritized.
- Evidence from randomized controlled trials was used to inform therapy decisions.
- Focus on highest levels of evidence for acute asthma management.
Main Results:
- Beta agonists and systemic corticosteroids are foundational treatments for acute asthma.
- Ipratropium bromide and intravenous magnesium sulfate show promise for severe asthma, potentially reducing hospital admissions.
- Antibiotics, intravenous beta agonists, and aminophylline offer limited benefit and may increase adverse effects.
Conclusions:
- Evidence-based acute asthma management includes beta agonists, systemic corticosteroids, and potentially ipratropium bromide or magnesium sulfate for severe cases.
- Discharge planning should incorporate a 5-7 day course of systemic corticosteroids and consider inhaled corticosteroids to prevent relapses.
- Asthma education and follow-up are essential for long-term management and improved quality of life.