THÔNG TIN TÀI LIỆU
Standard medications for acute asthma treatment include short-acting β-agonists (SABAs), anticholinergics, and systemic corticosteroids Children with severe exacerbations should receive high-dose SABA and ipratropium bromide in addition to prompt (within hour of arrival) systemic corticosteroids Such patients often require frequent, possibly continuous, SABA as well, following initial treatments Intravenous (IV) magnesium sulfate should be considered early in the ED course for patients with severe exacerbations, and those not improving after multiple inhaled bronchodilator treatments Emergency physicians should consider prescribing inhaled corticosteroids (ICSs) based on the degree of asthma control Current Evidence Asthma is a chronic inflammatory disease of the lower airways characterized by bronchial hyperresponsiveness and reversible bronchospasm While there is common pathophysiology for patients with asthma, the phenotype is rather heterogeneous, likely due to many interacting factors including the level of airway inflammation, degree of bronchial hyperresponsiveness, environmental exposures, and genetic differences (which may account for 60% to 80% of interindividual variance in treatment response) The National Asthma Education and Prevention Program (NAEPP) has published guidelines outlining diagnosis and management of acute and chronic asthma Many institutions have implemented local acute asthma clinical practice guidelines, which are associated with improved quality outcomes including shorter time to medication administration, shorter length of stay (LOS), and fewer medication prescription errors Goals of Treatment Acute asthma management is directed at improving symptoms by reversing bronchospasm and treating the underlying airway inflammation Goals of treatment include prompt administration of bronchodilators and systemic corticosteroids and identification of complications Clinical Considerations Clinical Recognition Asthma is characterized clinically by a pattern of periodic episodes of cough, wheeze, respiratory distress, and reversible bronchospasm While wheezing is the
Ngày đăng: 22/10/2022, 13:28
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