title: Management of acute asthma exacerbations.
abstract: OBJECTIVE
  Herein, we review the current guidelines for the management of children with an acute asthma exacerbation. We focus on management in the emergency department, inpatient, and ICU settings.
  
  
  RESULTS
  The most recent statistics show that the prevalence of asthma during childhood has decreased in certain demographic subgroups and plateaued in other subgroups. However, acute asthma accounts for significant healthcare expenditures. Although there are few, if any, newer therapeutic agents available for management of acute asthma exacerbations, several reports leveraging quality improvement science have shown significant reductions in costs of care as well as improvements in outcome.
  
  
  CONCLUSIONS
  Asthma is one of the most common chronic conditions in children and the most common reason that children are admitted to the hospital. Nevertheless, the evidence to support specific agents in the management of acute asthma exacerbations is surprisingly limited. The management of acute exacerbations focuses on reversal of bronchospasm, correction of hypoxia, and prevention of relapse and recurrence. Second-tier and third-tier agents are infrequently used outside of the ICU setting. Reducing the variation in treatment is likely to lead to lower costs and better outcomes.
authors.affiliation: aDivisions of Critical Care Medicine bHospital Medicine, Cincinnati Children's Hospital Medical Center cDepartment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
authors.forename: Erin K
authors.initials: EK
authors.lastname: Stenson
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Tchou
authors.forename: Derek S
authors.initials: DS
authors.lastname: Wheeler
mesh_terms: D000208:Acute Disease; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D003422:Critical Care; D018450:Disease Progression; D004636:Emergency Service, Hospital; D006760:Hospitalization; D006801:Humans; D058996:Quality Improvement
chemical_list: D018927:Anti-Asthmatic Agents