Status asthmaticus medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Initial severity assessment is evaluated using arterial blood gas and pulmonary function test and aggressive therapy is initiated to prevent progression to respiratory failure.

Medical Therapy

  • Non-invasive ventilation using C-PAP or tight-fitting face mask may be used to reduce the work of breathing without intubation.
  • Helium with oxygen mixture has shown to reduce airway resistance and thereby reduce the work of breathing and also improve bronchodilator efficacy.

Therapy Based on the Severity of the Disease Assessed by Arterial Blood Gas Analysis

Stage 1

Stage 2

Stage 3

Stage 4

References

  1. Scarfone RJ, Loiselle JM, Joffe MD, Mull CC, Stiller S, Thompson K et al. (2000) A randomized trial of magnesium in the emergency department treatment of children with asthma. Ann Emerg Med 36 (6):572-8. DOI:10.1067/mem.2000.111060 PMID: 11097697
  2. Bessmertny O, DiGregorio RV, Cohen H, Becker E, Looney D, Golden J et al. (2002) A randomized clinical trial of nebulized magnesium sulfate in addition to albuterol in the treatment of acute mild-to-moderate asthma exacerbations in adults. Ann Emerg Med 39 (6):585-91. PMID: 12023699
  3. Glover ML, Machado C, Totapally BR (2002) Magnesium sulfate administered via continuous intravenous infusion in pediatric patients with refractory wheezing. J Crit Care 17 (4):255-8. DOI:10.1053/jcrc.2002.36759 PMID: 12501154
  4. Blitz M, Blitz S, Beasely R, Diner BM, Hughes R, Knopp JA et al. (2005) Inhaled magnesium sulfate in the treatment of acute asthma. Cochrane Database Syst Rev (2):CD003898. DOI:10.1002/14651858.CD003898.pub2 PMID: 15846687
  5. Press S, Lipkind RS (1991) A treatment protocol of the acute asthma patient in a pediatric emergency department. Clin Pediatr (Phila) 30 (10):573-7. PMID: 1934839

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