[Acute asthma in children; guidelines by pediatric pulmonologists for diagnosis and treatment].
The diagnostic phase in a child with acute asthma should be short and comprise a brief history-taking, inspection and auscultation of the thorax, transcutaneous oxygen measurement and, if possible, peak flow measurement. Blood picture. sputum culture and chest X-ray may be included in the diagnostics if indicated. The primary treatment consists of administration of bronchodilators (beta-2 sympathicomimetics) by inhalation, using a spacer. Repeated inhalation of salbutamol and ipratropium may be necessary. In case of inadequate improvement (spraying necessary every 3 hours for 24-48 hours), hospitalization and systemic administration of corticosteroids are indicated. Other reasons for hospitalization are a transcutaneous oxygen saturation lower than 91%, complications such as subcutaneous emphysema and pneumothorax, exhaustion of child or parents, and rapid aggravation of the clinical picture with rising Pco2 and falling pH in capillary or arterial blood.
van Nierop
J C
JC
Emma Kinderzickenhuis AMC, afd. Kinderlongziekten, Amsterdam.
van Aalderen
W M
WM
Brinkhorst
G
G
Oosterkamp
R F
RF
de Jongste
J C
JC
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000336:Aerosols; D001249:Asthma / Q000175:diagnosis* / Q000628:therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002648:Child; D006760:Hospitalization; D006801:Humans; D008991:Monitoring, Physiologic; D009330:Nebulizers and Vaporizers; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D000336:Aerosols; D001993:Bronchodilator Agents