Acute severe asthma

Area of Science:

• Emergency Medicine
• Pulmonology
• Clinical Practice Guidelines

Background:

• Acute asthma exacerbations are frequent emergency department visits.
• Existing evidence-based guidelines for asthma exacerbations show significant variation.
• This variability stems from a limited evidence base for certain recommendations.

Purpose of the Study:

• To define high-risk groups for acute asthma exacerbations.
• To discuss asthma phenotypes and assessment of severe exacerbations.
• To emphasize management strategies for severe acute asthma, summarizing best evidence and controversies.

Main Methods:

• Review of existing evidence-based guidelines for acute asthma exacerbations.
• Analysis of treatment variations in drugs, doses, and regimens.
• Discussion of controversies in acute asthma management.

Main Results:

• Regular review and assessment of treatment response are crucial for managing asthma exacerbations.
• Severe and life-threatening exacerbations require early, stepwise intravenous treatment.
• Emerging modalities like non-invasive ventilation and high-flow nasal oxygen have limited current evidence.

Conclusions:

• Standardization of acute asthma exacerbation management is needed due to guideline variations.
• Prioritizing early intravenous treatment and regular reassessment is key for severe cases.
• Further research is required to support the use of novel respiratory support modalities.