Pediatric status asthmaticus

Crit Care Clin. 2013 Apr;29(2):153-66. doi: 10.1016/j.ccc.2012.12.001. Epub 2013 Feb 4.

Abstract

Status asthmaticus is a frequent cause of admission to a pediatric intensive care unit. Prompt assessment and aggressive treatment are critical. First-line or conventional treatment includes supplemental oxygen, aerosolized albuterol, and corticosteroids. There are several second-line treatments available; however, few comparative studies have been performed and in the absence of good evidence-based treatments, the use of these therapies is highly variable and dependent on local practice and provider preference. In this article the pathophysiology and treatment of status asthmaticus is discussed, and the literature regarding second-line treatments is critically assessed to apply an evidence basis to the treatment of this severe disease.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use*
  • Airway Obstruction / therapy
  • Albuterol / administration & dosage
  • Albuterol / therapeutic use*
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / therapeutic use*
  • Blood Gas Analysis
  • Bronchodilator Agents / administration & dosage
  • Bronchodilator Agents / therapeutic use
  • Child
  • Humans
  • Intensive Care Units, Pediatric
  • Intubation, Intratracheal / adverse effects
  • Intubation, Intratracheal / methods
  • Intubation, Intratracheal / standards
  • Noninvasive Ventilation / methods
  • Oxygen Inhalation Therapy*
  • Positive-Pressure Respiration / methods
  • Risk Factors
  • Severity of Illness Index
  • Status Asthmaticus / diagnosis
  • Status Asthmaticus / physiopathology
  • Status Asthmaticus / therapy*
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents
  • Bronchodilator Agents
  • Albuterol