Update on the management of status asthmaticus

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P Downey1, R Cox

  • 1Department of Emergency Medicine, Alberta Children's Hospital, Calgary, Canada.

Current Opinion in Pediatrics
|June 1, 1996
PubMed

Insights

This study reviews current treatments for severe childhood asthma attacks (status asthmaticus). Key therapies include oxygen, inhaled medications, and corticosteroids, with other options for critical cases.

Area of Science:

  • Pediatrics
  • Pulmonology
  • Emergency Medicine

Background:

  • Asthma is a prevalent and severe condition in children, leading to significant healthcare costs and mortality.
  • Status asthmaticus, a severe asthma exacerbation, requires prompt and effective therapeutic interventions.

Purpose of the Study:

  • To examine current therapeutic strategies for managing status asthmaticus in pediatric patients.
  • To review the evidence supporting various treatment modalities for severe asthma exacerbations.

Main Methods:

  • Literature review of recent trends in the management of status asthmaticus.
  • Analysis of the efficacy and indications for different pharmacological and non-pharmacological interventions.

Main Results:

  • Oxygen, inhaled beta-adrenergic agonists, and corticosteroids are primary treatments.
  • Ipratropium bromide aids bronchodilation in non-responders; theophylline's role in acute therapy is inconclusive.
  • Antibiotics are reserved for infections; magnesium sulfate and heliox may benefit critically ill children.
  • Mechanical ventilation carries risks, with permissive hypercapnia potentially reducing barotrauma.

Conclusions:

  • Standard therapy for status asthmaticus involves oxygen, inhaled beta-agonists, and corticosteroids.
  • Adjunctive therapies like ipratropium bromide, magnesium sulfate, and heliox have specific roles.
  • Preventive measures include allergen/tobacco avoidance, corticosteroid use, and adherence to treatment.

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