Management of status asthmaticus in children.
Asthma is a common chronic inflammatory disorder of the airways characterized by recurrent wheezing, breathlessness, and coughing. Acute exacerbations of asthma can be life-threatening; annual worldwide estimated mortality is 250,000 and most of these deaths are preventable. While most of the acute exacerbations can be managed successfully in the emergency room, few children have severe exacerbations requiring intensive care. Mainstay of treatment for status asthmaticus are inhaled β2 agonist and anticholinergic agents, oxygen along with corticosteroids. Children who do not respond well to initial treatment require parenteral β2 agonist and magnesium. Rarely, sick children need parenteral aminophylline infusion and mechanical ventilation. Guidelines for diagnosis, treatment, ventilator management and supportive care for status asthmaticus in children are discussed in the protocol.
Saharan
Sunil
S
Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 10029, India.
Lodha
Rakesh
R
Kabra
Sushil K
SK
D002648:Child; D006801:Humans; D013224:Status Asthmaticus / Q000150:complications / Q000175:diagnosis / Q000628:therapy*
Chest. 1996 May;109(5):1256-61
8625677
Crit Care Med. 1996 Mar;24(3):379-80
8625622
J Allergy Clin Immunol. 1988 Jun;81(6):1101-9
3132498
Arch Dis Child. 1998 Apr;78(4):395-6
9623413
Pediatr Crit Care Med. 2004 Jul;5(4):337-42
15215002
Chest. 2004 Nov;126(5):1480-9
15539716
Eur Respir J. 1998 Mar;11(3):694-701
9596123
Allergy. 2005 Jan;60(1):23-9
15575926
Pediatrics. 2005 Nov;116(5):1127-33
16263999
Chest. 2001 Jun;119(6):1913-29
11399724
Lancet. 2006 Aug 26;368(9537):733-43
16935684
Annu Rev Med. 1996;47:161-8
8712770
Chest. 2001 May;119(5):1480-8
11348957
Allergy. 2004 May;59(5):469-78
15080825
Ann Allergy Asthma Immunol. 2006 Mar;96(3):454-9
16597080
N Engl J Med. 2000 Sep 7;343(10):689-94
10974132
Ann Emerg Med. 1995 Oct;26(4):480-6
7574132
J Rheumatol. 1998 Oct;25(10):1995-2002
9779857
Chest. 2003 Oct;124(4):1312-7
14555560
Anaesthesia. 2007 Jan;62(1):34-42
17156225
Acta Paediatr. 1999 Aug;88(8):835-40
10503681
Am J Med. 1983 Jun;74(6):1005-9
6407304
Intensive Care Med. 1996 Sep;22(9):972-6
8905436
Crit Care Med. 1993 Oct;21(10):1479-86
8403956
Am J Dis Child. 1984 Jun;138(6):574-6
6720644
JAMA. 1983 Apr 15;249(15):2043-6
6403719
J Asthma. 1994;31(3):201-7
8195062
Thorax. 2005 Sep;60(9):740-6
16055613
Ann Emerg Med. 2005 Jul;46(1):29-36
15988423
Chest. 2003 Mar;123(3):891-6
12628893
J Allergy Clin Immunol. 2010 Jun;125(6):1178-87; quiz 1188-9
20513517
Arch Pediatr Adolesc Med. 1996 Sep;150(9):914-8
8790120
BMJ. 1996 Jan 13;312(7023):79-82
8555932
Arch Dis Child. 2005 Jan;90(1):74-7
15613519
J Pediatr. 2004 Aug;145(2):172-7
15289762
J Pediatr. 2000 Jul;137(1):73-7
10891825
Ann Emerg Med. 1994 Jun;23(6):1236-41
8198296
Clin Exp Allergy. 2009 Feb;39(2):193-202
19187331
Clin Rev Allergy Immunol. 2001 Jun;20(3):385-97
11413905
Arch Dis Child. 2010 Jul;95(7):540-3
20522464
J Pediatr. 2004 Mar;144(3):333-7
15001938
J Appl Physiol. 1972 Mar;32(3):391-6
4551505