title: [Severe acute asthma].
abstract: A severe acute asthma attack is defined by the presence of clinical signs of severity and/or a value of peak expiratory flow (PEF) < 30% predicted. The treatment is based mainly on inhaled beta 2 agonists and systemic corticosteroids. Nebulization is the route of administration of choice, because of its simplicity, its efficacy and its tolerability. Anticholinergics are indicated in association with nebulised beta 2 agonists. Response to treatment must be evaluated within an hour, permitting the early detection of "responders" or "non-responders" to the initial treatment. The great majority of deaths from acute asthma are avoidable, underlining the importance of preventive measures. Prevention is based on the control of the asthma by personalized ongoing treatment based on long-term inhaled corticosteroids and the use of oral corticosteroids in the treatment of exacerbations. However, a severe acute asthma attack can appear at any stage of severity of asthma, including controlled asthma, justifying the utilisation of action plans to treat exacerbations.
authors.affiliation: Service de pneumologie Fondation Hôpital Saint-Joseph 75674 Paris. ssalmeron@hopital-saint-joseph.org
authors.forename: Sergio
authors.initials: S
authors.lastname: Salmeron
authors.forename: Marie-Luce
authors.initials: ML
authors.lastname: Robin
authors.forename: Laurence
authors.initials: L
authors.lastname: Kettaneh
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Blanc
mesh_terms: D000208:Acute Disease; D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002423:Cause of Death; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005602:France / Q000453:epidemiology; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D011322:Primary Prevention / Q000379:methods; D012307:Risk Factors; D012720:Severity of Illness Index; D013256:Steroids
chemical_list: D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; D020024:Leukotriene Antagonists; D013256:Steroids