Management of Severe Asthma Exacerbation in Children

Abstract

Background: Asthma is a common disease in children and acute severe asthma exacerbation can be life-threatening. This article aims to review recent advances in understanding of risk factors, pathophysiology, diagnosis and treatment of severe asthma exacerbation in children. Data sources: Articles concerning severe asthma exacerbation in children were retrieved from PubMed. Literatures were searched with MeSH words "asthma", "children", "severe asthma exacerbation" and relevant cross references. Result(s): Severe asthma exacerbation in children requires aggressive treatments with beta2-agonists, anticholinergics, and corticosteroids. Early initiation of inhaled beta-agonists and systemic use of steroids are recommended. Other agents such as magnesium and aminophylline have some therapeutic benefits. When intubation and mechanical ventilation are needed, low tidal volume, controlled hypoventilation with lower-than-traditional respiratory rates and permissive hypercapnia can be applied. Conclusion(s): Researchers should continue to detect the risk factors, pathophysiology, diagnosis and treatment of severe asthma exacerbation in children. More studies especially randomized controlled trials are required to evaluate the efficacy and safety of standard and new therapies. © 2011 Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg.