Emergency department treatment of asthma in children: A review

Lee, Moon O.; Sivasankar, Shyam; Pokrajac, Nicholas; Smith, Cherrelle; Lumba‐Brown, Angela

doi:10.1002/emp2.12224

Cited by 9 publications

(12 citation statements)

References 88 publications

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“…There is a scarcity of adequately designed and powered trials that compare the efficacy and safety of intravenous MgSO 4 with other parenteral bronchodilators in acute asthma. The available evidence is further marred by a lack of uniformity in the use of clinical rating scales and other outcome parameters [ 17 ]. The bulk of evidence on intravenous MgSO 4 hence stems from observational studies and a limited number of placebo-controlled studies.…”

Section: Mgso 4 As the First Parenteral Bronchodilator: Scope And Limitationsmentioning

confidence: 99%

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Stating the obvious: intravenous magnesium sulphate should be the first parenteral bronchodilator in paediatric asthma exacerbations unresponsive to first-line therapy

Erumbala

Anzar

Tonbari

et al. 2021

Breathe

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What is the most appropriate second-line intravenous bronchodilator treatment when a child with a severe asthma attack is not responsive to initial inhaled therapy? The second-line treatment options for acute asthma include parenteral β2-agonists, methylxanthine and magnesium sulphate (MgSO4). There is a poor evidence-base to inform this decision. This review argues that intravenous MgSO4 is the obvious treatment of choice for this situation as the initial treatment based on current knowledge. We describe the mode of action, scope and limitations of MgSO4, safety profile, economic impact, comparisons of the alternatives, and finally, what the guidelines say. This review explores the suitability of intravenous MgSO4 as a pragmatic and safe initial second-line therapy for children unresponsive to initial asthma management.

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Section: Mgso 4 As the First Parenteral Bronchodilator: Scope And Limitationsmentioning

confidence: 99%

“…An alternate β 2 -agonist often employed parenterally in acute asthma is terbutaline. Its use has been associated with severe sympathomimetic effects such as tachycardia, arrhythmia, and myocardial ischaemia [ 17 ].…”

Section: Mgso 4 As the First Parenteral Bronchodilator: Scope And Limitationsmentioning

confidence: 99%

Stating the obvious: intravenous magnesium sulphate should be the first parenteral bronchodilator in paediatric asthma exacerbations unresponsive to first-line therapy

Erumbala

Anzar

Tonbari

et al. 2021

Breathe

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“…The use of heliox (80%–20% or 70–30% helium to oxygen) as a driver, improves gas exchange and reduces the work of breathing as well as the need for mechanical ventilation for treatment of acute respiratory distress 67 67 …”

Section: Nebulizersmentioning

confidence: 99%

“…The use of heliox (80%-20% or 70-30% helium to oxygen) as a driver, improves gas exchange and reduces the work of breathing as well as the need for mechanical ventilation for treatment of acute respiratory distress. 67 While it is not commonly used in routine care, it can be used as an adjunct therapy to improve outcomes only if the patient does not require >30% oxygen. 67…”

Section: Driving Gas For Jet Nebulizersmentioning

confidence: 99%

Aerosolized drug delivery in awake and anesthetized children to treat bronchospasm

Anderson

Clarke

Ungern‐Sternberg

2021

Pediatric Anesthesia

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Bronchospasm is a common respiratory adverse event in pediatric anesthesia. Firstline treatment commonly includes inhaled salbutamol. This review focuses on the current best practice to deliver aerosolized medications to awake as well as anesthetized pediatric patients and discusses the advantages and disadvantages of various administration techniques. Additionally, we detail the differences between various airway devices used in anesthesia. We highlight the unmet need for innovation of orally inhaled drug products to deliver aerosolized medications during pediatric respiratory critical events such as bronchospasm. It is therefore important that clinicians remain up to date with the best clinical practice for aerosolized drug delivery in order to prevent and efficiently treat pediatric patients experiencing life-threatening respiratory emergencies.

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“…Pediatric asthma has various examples as indicated by the kids' age. In the preschoolers (0-5 years of age), intense wheeze is frequently incited by diseases of the lower aviation routes, while in the school-matured kids (6 years and more established) it as a rule means fundamental asthma and allergy [5]. These distinctions represent explicit occasional examples in the quantity of ED visits for asthma.…”

Section: Introductionmentioning

confidence: 99%

An Emergency Department Management on Acute Asthma Exacerbations in Children Younger than 12 Years

Latif

Zahoor²,

Khalid

2021

JPRI

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Objectives: The main objective of the study is to clinically audit and analyse the acute asthma exacerbations in children younger than 12 years regarding management of emergency department. Methods: This clinical audit was done in Bahawal Victoria Hospital, Bahawalpur during January 2020 till June 2020. We retrospectively revised all the files of children aged 0–12 years who were visited for acute asthma in the Paediatric ED of Hospital. All the patients with a diagnosis of “acute asthma,” “wheezing bronchitis,” and “bronchospasm” were included. Results: A total of 864 patients were seen in the Emergency Department during the study. Of these, a total of 293 patients were seen for a presentation of acute asthma. As some patients had multiple visits, the 293 records represented 278 unique patients. For assessing age and gender distribution of the patients, only data from the first visit were used. Otherwise, each record was treated independently for the purpose of analyses. Conclusion: It is concluded that acute asthma management still remains an area of medical practice that continues to have long-standing difficulties.

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Emergency department treatment of asthma in children: A review

Cited by 9 publications

References 88 publications

Stating the obvious: intravenous magnesium sulphate should be the first parenteral bronchodilator in paediatric asthma exacerbations unresponsive to first-line therapy

Stating the obvious: intravenous magnesium sulphate should be the first parenteral bronchodilator in paediatric asthma exacerbations unresponsive to first-line therapy

Aerosolized drug delivery in awake and anesthetized children to treat bronchospasm

An Emergency Department Management on Acute Asthma Exacerbations in Children Younger than 12 Years

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