[Treatment of acute asthma]

Asthma is a chronic inflammatory disorder of the airways with an increasing prevalence over the last 20 years worldwide. Exacerbation of asthma is defined as rapidly progressive increase in shortness of breath, cough, wheezing, or chest tightness, or some combination of these symptoms and a decrease in expiratory airflow that can be qualified by measurement of pulmonary function such as the peak expiratory flow rate (PEFR) and FEV1. All patients with asthma are at risk of having exacerbations and it has been described previously as acute asthma, asthma or status asthmaticus. A number of medical condition such as chronic obstructive pulmonary disease (COPD), congestive heart failure, upper airway obstruction, hyperventilation syndrome, or vocal cord dysfunction may mimic the diagnosis of asthma attack, however it can be differentiated by history, physical examination, and some laboratory tests. It is a common medical emergency. The severity of exacerbations may range from mild to life threatening and immediate optimal management is of importance to prevent mortality. Morbidity and mortality are mostly related with inadequate emergency treatment and delay in referring to hospital. This review mainly focuses on the treatment of acute asthma considering the recommendations of GINA guideline.