Mar 23, 2002

Management of children with severe asthma exacerbation in the emergency department

Paediatric Drugs
Benjamin Volovitz, Moshe Nussinovitch

Abstract

Although acute asthma is a very common cause of emergency department visits in children, there is as yet insufficient evidence for the establishment of a standardized treatment protocol. The aim of this review is to describe updated information on the management of asthma exacerbations in the pediatric emergency department. Oxygen is the first-line treatment of acute asthma exacerbations in the emergency department to control hypoxemia. It is accompanied by the administration of beta(2)-adrenoceptor agonists followed by corticosteroids. beta(2)-Adrenoceptor agonists have traditionally been administered by nebulization, although spacers have recently been introduced and proven, in many cases, to be as effective as nebulization. Oral prednisolone, with its reliability, simplicity, convenience and low cost, should remain the treatment of choice for the most severe asthma exacerbations, when the lung airways are extremely contracted and filled with secretions. Recently, several studies have shown that high-dose inhaled corticosteroids are at least as effective as oral corticosteroids in controlling moderate to severe asthma attacks in children and therefore should be considered an alternative treatment to oral corticosteroids in mo...Continue Reading

  • References48
  • Citations2
  • References48
  • Citations2

Citations

Mentioned in this Paper

Ipratropium Bromide
Lung
Emergency Care
Prednisolone Oral Product
Broncholytic Effect
Contraction (Finding)
Corticosteroids, topical for treatment of hemorrhoids and anal fissures
Magnesium Sulfate
Adrenal Cortex Hormones
Asthma

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