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Status Asthmaticus in Children*: A Review

Heinrich A. Werner, MD
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*From the Division of Critical Care, University of Kentucky Children’s Hospital, Lexington, KY.

Correspondence to: Heinrich A. Werner, MD, Division of Critical Care, University of Kentucky Children’s Hospital, Lexington, KY 40536; e-mail: hwerner@pop.uky.edu



Chest. 2001;119(6):1913-1929. doi:10.1378/chest.119.6.1913
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About 10% of American children have asthma, and its prevalence, morbidity, and mortality have been increasing. Asthma is an inflammatory disease with edema, bronchial constriction, and mucous plugging. Status asthmaticus in children requires aggressive treatment with β-agonists, anticholinergics, and corticosteroids. Intubation and mechanical ventilation should be avoided if at all possible, as the underlying dynamic hyperinflation will worsen with positive-pressure ventilation. If mechanical ventilation becomes necessary, controlled hypoventilation with low tidal volume and long expiratory time may lessen the risk of barotrauma and hypotension. Unusual and nonestablished therapies for severe asthma are discussed.

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