E. Ciofu *, D. Orășeanu *, C. Ulmeanu *, Nicoleta Bâscă **, Irina Drăgușanu *, Daniela Păcurar *
* Prof. Dr. Eugen Ciofu, Conf. Dr. Dumitru Orășeanu, Conf. Dr. Coriolan, Ulmeanu, Dr. Irina Drăgușanu, Dr. Daniela Păcurar – Clinica de Pediatrie Spitalul Clinic Central de Copii “Grigore Alexandrescu” București
** Dr. Nicoleta Bâscă, Institutul de Pneumoftiziologie “Marius Nasta” București
Abstract
Status asthmaticus is definited as acute bronchospasm that is resistant to bronchodilatator therapy. Most children with status asthmaticus present with a history of gradual deterioration over days, but a subgroup of patients will have suffered rapid decompensation over hours. This article focuses on the strategies for the initial stabilization and management of the child with life-threatening status asthmaticus. Oxigen, inhaled adrenerg ic agonists and corticosteroids remain the cornerstones of therapy for the child with a severe exacerbation of asthma. lpratropium bromide provides additional bronchodilatation in the patient who does not respond to standard therapy. Theophilline may have a role in chronic outopatient management of asthma, but the data supporting the addition of this medication in acute therapy of status asthmaticus are inconclusive. Antibiotics are only indicated in children with asthma complicated by infections, such as sinusitis or pneumonia. Magnesium sulfate or Heliox may have a role in helping the asthmatic child who is critically ill and for whom other interventions have failed. Mechanical ventilation has many complications.