Treatment of acute exacerbation of asthma – Related resources

Cochrane reviews

• There is insufficient evidence on the effect of oral leukotriene receptor antagonists in adults and children with acute asthma .
• Inhaled steroids given in the emergency department for acute asthma appear to reduce admission rates in patients who are not receiving systemic steroids .
• High dose ICS therapy does probably not provide added benefit to oral corticosteroids following emergency department discharge .
• Intravenous beta-2-agonists appear to produce no benefits as compared to treatment given by inhalation .
• Continuous nebulized beta-agonists are more effective than intermittent beta-agonists in the treatment of severe acute asthma .
• The evidence on the benefits of the application of non-invasive positive pressure ventilation (NPPV) in patients suffering from status asthmaticus is insufficient for conclusions .
• In acute asthma, the use of intravenous aminophylline appears not to result in better bronchodilatation than inhaled beta2-agonists alone. Aminophylline causes adverse effects .
• A short course of corticosteroids following assessment for an acute exacerbation of asthma reduces the number of relapses and decreases beta-agonist use without an apparent increase in side effects .
• Educational interventions applied in the emergency department may reduce subsequent asthma admissions to hospital .
• Administration of helium-oxygen mixtures in the initial treatment of patients with acute asthma may not provide any significant benefits .

Clinical guidelines

• British guideline on the management of asthma. British Thoracic Society (BTS) / Scottish Intercollegiate Guidelines Network (SIGN). Guideline No. 101, 2008 / Revised 2011
• Diagnosis and management of asthma. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008.

Literature

• Bateman ED, Hurd SS, Barnes PJ et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 2008;31(1):143-78.