A review of the use of adjunctive therapies in severe acute asthma exacerbation in critically ill children. (August 2014)

• Record Type: Journal Article
• Authors: Wong, Judith JM; Lee, Jan Hau; Turner, David A; Rehder, Kyle J
• Is Part Of: Expert review of respiratory medicine. Volume 8:Number 4(2014)
• Page Start: 423
• Page End: 441
• Publication Date: 2014-08
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Treatment -- Periodicals; 616.2005
• DOI: 10.1586/17476348.2014.915752
• Languages: English
• ISSNs: 1747-6348

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p>Asthma is a common and potentially life threatening childhood condition. Asthma involves not only chronic airway remodeling, but may also include frequent exacerbations resulting from bronchospasm, edema, and mucus production. In children with severe exacerbations, standard therapy with β₂-agonists, anti-cholinergic agents, oxygen, and systemic steroids may fail to reverse the severe airflow obstruction and necessitate use of adjunctive therapies. These therapies include intravenous or inhaled magnesium, inhaled helium-oxygen mixtures, intravenous methylxanthines, intravenous β₂-agonists, and intravenous ketamine. Rarely, these measures are not successful and following the initiation of invasive mechanical ventilation, inhaled anesthetics or extracorporeal life support may be required. In this review, we discuss the mechanisms and evidence for adjunctive therapies in the setting of severe acute asthma exacerbations in children.</p> </abstract>