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Acute asthma.

D Bohn1, N Kissoon

  • 1Department of Critical Care Medicine, The Hospital for Sick Children, Toronto (Dr. Bohn) and the Department of Anesthesia and Pediatric Intensive Care, University of Florida, Jacksonville (Dr. Kissoon).

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|June 12, 2003
PubMed
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Acute severe asthma in children requires prompt management with beta-agonists and steroids. Intensive care unit (ICU) interventions, including advanced therapies and ventilation, improve outcomes for non-responsive cases.

Area of Science:

  • Pediatric Emergency Medicine
  • Pulmonology
  • Critical Care

Background:

  • Asthma is a leading cause of pediatric emergency visits, causing significant morbidity and mortality.
  • Acute asthma attacks necessitate a stepwise treatment approach, with beta-agonists and steroids as primary interventions.

Purpose of the Study:

  • To review the management strategies for acute severe asthma in children.
  • To highlight the approach to emergency department and intensive care unit (ICU) treatment.

Main Methods:

  • Review of standard and nonstandard pharmacologic therapies for acute severe asthma.
  • Discussion of mechanical ventilatory support strategies in the ICU.
  • Examination of recent advancements in monitoring and treatment.

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Main Results:

  • Most children respond to initial emergency department treatment.
  • ICU admission is required for treatment failures, with intensified therapies aimed at avoiding intubation.
  • Improved monitoring and ventilatory strategies have reduced ICU morbidity and mortality.

Conclusions:

  • Effective management of acute severe asthma involves a stepwise approach, escalating care as needed.
  • Advancements in critical care have improved outcomes for children with severe asthma exacerbations.
  • Ongoing research into asthma mechanisms promises novel therapeutic developments.