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Published on: November 4, 2010

Pediatric status asthmaticus

Christopher L Carroll1, Kathleen A Sala

  • 1Division of Pediatric Critical Care, Department of Pediatrics, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, USA. ccarrol@ccmckids.org

Critical Care Clinics
|March 30, 2013
PubMed

Insights

Status asthmaticus, a severe asthma condition, requires prompt pediatric intensive care. This review critically assesses second-line treatments to establish evidence-based guidelines for this critical pediatric condition.

Area of Science:

  • Pediatric Intensive Care Medicine
  • Pulmonology
  • Emergency Medicine

Background:

  • Status asthmaticus is a common reason for pediatric intensive care unit (PICU) admission.
  • Prompt assessment and aggressive management are crucial for favorable outcomes.
  • Current first-line treatments include oxygen, inhaled albuterol, and corticosteroids.

Purpose of the Study:

  • To discuss the pathophysiology of status asthmaticus.
  • To critically evaluate the existing literature on second-line treatment options.
  • To provide an evidence basis for managing severe pediatric asthma exacerbations.

Main Methods:

  • Literature review of pathophysiology and treatment of status asthmaticus.
  • Critical assessment of studies on second-line therapies.
  • Synthesis of evidence to guide clinical practice.

Main Results:

  • Status asthmaticus pathophysiology involves complex airway inflammation and bronchoconstriction.
  • Limited comparative studies exist for second-line treatments, leading to variable clinical practice.
  • Evidence for therapies like magnesium sulfate, ketamine, and heliox is reviewed.

Conclusions:

  • There is a need for more high-quality, comparative studies on second-line treatments for status asthmaticus.
  • Evidence-based guidelines are needed to standardize the variable use of these therapies.
  • Optimizing the treatment of status asthmaticus can improve PICU outcomes.

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