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Published on: November 4, 2010
Management of acute asthma exacerbations in children
1Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. benjamin@volovitz.com
Insights
This review offers practical guidance for preventing and managing childhood asthma attacks, emphasizing parent education and the role of inhaled corticosteroids for better control at home and in emergency settings.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Respiratory Medicine
Background:
- Current guidelines for childhood asthma exacerbations lack comprehensive answers.
- Effective management strategies require updated practical information for parents and clinicians.
Purpose of the Study:
- To provide up-to-date information on preventing and controlling asthma attacks in children.
- To review a 20-year clinical experience with inhaled corticosteroids in pediatric asthma management.
- To empower parents with knowledge for home-based asthma control.
Main Methods:
- Literature review of current asthma management guidelines and research.
- Analysis of a 20-year clinical experience from a tertiary asthma clinic.
- Discussion of pharmacologic treatments and post-discharge care.
Main Results:
- Inhaled corticosteroids show efficacy in managing acute pediatric asthma exacerbations.
- Parental education is crucial for preventing, detecting, and controlling asthma attacks.
- Structured management programs enhance home-based asthma control.
Conclusions:
- Optimizing parental knowledge and skills is key to effective asthma management in children.
- Inhaled corticosteroids are valuable tools for acute exacerbations in pediatric asthma.
- Comprehensive asthma management programs improve outcomes for children with asthma.
Abstract:
The management of acute asthma exacerbations in children remains controversial and the latest guidelines (Expert Panel Report [EPR]-3 2007 and the Global Initiative of Asthma 2008) leave several questions unanswered. This review summarizes the most up-to-date information on the practical prevention and control of asthma attacks in children, and describes the 20-year experience of a major tertiary asthma clinic with the administration of inhaled corticosteroids in this setting. The following subjects are discussed: the knowledge and skills required by the parents regarding asthma and its treatment, how to prevent or minimize exacerbations in asthmatic children, the drugs used in the treatment of exacerbations and their order of administration, and the steps to follow after discharge from the emergency department or after a severe asthma exacerbation. The efficacy of inhaled corticosteroids in the management of acute asthma exacerbations in children, both at home and in the emergency department, is discussed in detail. The goal of asthma-management programs is to arm parents with the skills and knowledge to prevent, detect and successfully control most exacerbations of asthma in children at home.
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