Management of severe asthma in children

Background Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity from chronic disease. When uncontrolled, asthma can place significant limits on daily life, and is sometimes fatal. Objective This article describes the initial assessment and management of status asthmaticus in children. Discussion Status asthmaticus is a medical emergency in which asthma symptoms are refractory to initial bronchodilator therapy. Patients may report chest tightness, rapidly progressive shortness of breath, dry cough and wheezing. Typically, patients present a few days after the onset of a viral respiratory illness, following exposure to potent allergens or irritants, or after exercise in a cold environment, however, they can also present with sudden onset of symptoms with an unknown trigger. Early recognition and initiation of therapy is vital in preventing severe complications such as respiratory failure. Aggressive treatment with beta-agonists, anticholinergics and corticosteroids remains the gold standard for this condition.