Related Experiment Video
Updated: May 30, 2026
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Acute bronchial asthma
Sudhanshu Grover1, Atul Jindal, Arun Bansal
1Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Insights
Acute asthma is a common pediatric emergency. Initial treatment includes oxygen, inhaled medications, and steroids for severe cases, with magnesium sulfate as a safe alternative for persistent symptoms.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Medicine
- Clinical Management
Background:
- Acute asthma is a frequent reason for pediatric emergency visits.
- Asthma exacerbations present with acute respiratory distress and wheezing.
- Clinical assessment categorizes severity as mild, moderate, or severe.
Purpose of the Study:
- To outline the management protocol for acute asthma in children.
- To detail initial and alternative therapeutic strategies.
- To emphasize differential diagnosis and escalation of care.
Main Methods:
- Clinical evaluation of asthma severity.
- Administration of inhaled bronchodilators and corticosteroids.
- Use of systemic steroids and anticholinergics for severe cases.
- Diagnostic workup to exclude other causes of wheezing.
- Consideration of intravenous therapies for refractory cases.
Main Results:
- Initial therapy involves oxygen, inhaled beta-2 agonists, budesonide, and systemic steroids for severe asthma.
- Differential diagnoses like pneumonia must be excluded.
- Intravenous magnesium sulfate is a safe and effective option for inadequate response.
- Severe cases may require intensive care unit (ICU) admission and ventilatory support.
Conclusions:
- A structured approach to acute pediatric asthma management is crucial.
- Timely administration of appropriate inhaled and systemic therapies improves outcomes.
- Magnesium sulfate offers a valuable therapeutic option for severe or refractory asthma.
- Exclusion of alternative diagnoses and escalation of care are vital for critically ill children.
Abstract:
Acute asthma is the third commonest cause of pediatric emergency visits at PGIMER. Typically, it presents with acute onset respiratory distress and wheeze in a patient with past or family history of similar episodes. The severity of the acute episode of asthma is judged clinically and categorized as mild, moderate and severe. The initial therapy consists of oxygen, inhaled beta-2 agonists (salbutamol or terbutaline), inhaled budesonide (three doses over 1 h, at 20 min interval) in all and ipratropium bromide and systemic steroids (hydrocortisone or methylprednisolone) in acute severe asthma. Other causes of acute onset wheeze and breathing difficulty such as pneumonia, foreign body, cardiac failure etc. should be ruled out with help of chest radiography and appropriate laboratory investigations in first time wheezers and those not responding to 1 h of inhaled therapy. In case of inadequate response or worsening, intravenous infusion of magnesium sulphate, terbutaline or aminophylline may be used. Magnesium sulphate is the safest and most effective alternative among these. Severe cases may need ICU care and rarely, ventilatory support.
Related Concept Videos
01:28Asthma I: Introduction
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:29Asthma-I: Introduction
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:13Asthma III: Clinical Manifestations
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features