title: Advances in acute asthma.
abstract: OBJECTIVE
  The purpose of this study is to highlight some of the recent findings related with the management of acute exacerbations in the context of the emergency department setting.
  
  
  RESULTS
  β₂-agonist heliox-driven nebulization significantly increased by 17% [95% confidence interval (CI) 5.2-29.4] peak expiratory flow, and decreased the rate of hospital admissions (risk ratio 0.77, 95% CI 0.62-0.98), compared with oxygen-driven nebulization. Other findings indicate that there is no robust evidence to support the use of intravenous or nebulized magnesium sulphate in adults with severe acute asthma, and that levalbuterol was not superior to albuterol regarding efficacy and safety in individuals with acute asthma. Finally, hyperlactatemia developed during the first hours of acute asthma treatment has a high prevalence, is related with the use of β₂-agonists and had no clinical consequences.
  
  
  CONCLUSIONS
  After a comprehensive review of the best quality pieces of literature published in the last year, it is possible to conclude that the goals of acute asthma management remain almost unchanged.
authors.affiliation: Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay.
authors.forename: Gustavo J
authors.initials: GJ
authors.lastname: Rodrigo
mesh_terms: D000208:Acute Disease; D058665:Adrenergic beta-1 Receptor Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000420:Albuterol / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D055416:Evidence-Based Emergency Medicine; D006371:Helium / Q000627:therapeutic use*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D065906:Hyperlactatemia / Q000139:chemically induced; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D009330:Nebulizers and Vaporizers; D010100:Oxygen / Q000627:therapeutic use*; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D058665:Adrenergic beta-1 Receptor Agonists; D001993:Bronchodilator Agents; D006371:Helium; C038949:heliox; D008278:Magnesium Sulfate; D000420:Albuterol; D010100:Oxygen