Status Asthmaticus
Abstract
The therapy of status asthmaticus must be rational. Thus it is important to evaluate: 1. the severity and duration of an asthmatic attack. 2. the degree of dehydration. 3. whether infection plays a role. 4. all medication previously administered. 5. any possible complication.
Treatment is as follows :
- Fluid and electrolyte therapy is important not only for the correction of dehydration and electrolyte disturbances but also for preventing inspissation of mucus in the bronchi. The best route of fluid administration is intravenous.
- Potassium iodide orally administered may be helpful as an expectorant.
- After hydration and normal acid-base balance have been established, epinephrine may be of benefit.
- Aminophylline is effective when administered intravenously. It should be used with extreme caution: the dose should not exceed 3 mg per kg of body weight, it should be given slowly and should not be given more frequently than every 8 hours.
- Corticosteroids should be administered, especially in cases who have received suppressive doses previously.
- Humidified oxygen administration is of the utmost importance.
- Antibiotics are recommended when infection is suspected.
- Management of complications.
References
BARTER, B. and ROBERTS, R.J.: Unusual case of aminophylline intoxication. Pediatrics 52 : 608 (1973).
BIERMAN, C.W.: Pneumomediastinum and pneumothorax complicating asthma in children. Am. J. Dis. Child. 114 : 42 (1967).
DEES, S.C.: Asthmatic Child: Development and course of asthma in children. Am. J. Dis. Child. 93 : 228 (1957).
DWORETZKY, M. and PHELSON, A.D. : Review of asthmatic patients hospitalized in the pavilion service of the New York Hospital from 1948 to 1963 with emphasis on mortality rate. J. Allergy 41 : 181 (1968).
PIERSON. W.E.; BIERMAN, C.W.; STAMM, S.J. and VAN ARSDEL, P.P. Jr.: Double blind trial of aminophylline in status asthmaticus. Pediatrics 48 : 642 (1971).
PIERSON, W.E.; BIERMAN, C.W. and KELLEY, V.C.: A double-blind trial of corticosteroid therapy in status asthmaticus. Pediatrics 54 : 282
(1974).
REISMAN, R.E.; FRIEDMAN, I. and ARBESMAN, C.E. : Severe status asthmaticus: Prolonged treatment with assisted ventilation. J. Allergy 43 : 37 (1968).
RICHARDS, W. and PATRICK, J.: Death from asthma in children. Am. J. Dis. Child. 110: 4 (1965).
SHAPIRO, G.G.; EGGLESTON P.A.; PIERSON, W.E.; RAY, C.G. and BIERMAN, C.W.: Double blind study of the effectiveness of a broadspectrum antibiotic in status asthmaticus. Pediatr. 53 : 867 (1974).
SIEGEL, S.C.: ACTH and the corticosteroids in the management of allergic disorders in children. J. Pediatr. 66 : 927 (1965).
TSUCHIYA, Y. and BUKANTZ, S.C.: Studies on status asthmaticus in children. J. Allergy 36 : 514 (1965).
WOOD, D.W.; DOWNS, J.J. and LECKS, HI.: The management of respiratory failure in childhood status asthmaticus: Experience with 30 episodes and evolution of a technique. J. Allergy 42 : 261 (1968).
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2017-05-26
Published 2017-05-29
