Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway.
Scand J Trauma Resusc Emerg Med. 2009 Sep 4;17:40. doi: 10.1186/1757-7241-17-40.
Acute severe asthma is one of the most common medical emergency situations in childhood, and physicians caring for acutely ill children are regularly faced with this condition. In this article we present a summary of the pathophysiology as well as guidelines for the treatment of acute severe asthma in children. The cornerstones of the management of acute asthma in children are rapid administration of oxygen, inhalations with bronchodilators and systemic corticosteroids. Inhaled bronchodilators may include selective b2-agonists, adrenaline and anticholinergics. Additional treatment in selected cases may involve intravenous administration of theophylline, b2-agonists and magnesium sulphate. Both non-invasive and invasive ventilation may be options when medical treatment fails to prevent respiratory failure. It is important that relevant treatment algorithms exist, applicable to all levels of the treatment chain and reflecting local considerations and circumstances.
急性重症哮喘是儿童最常见的急症之一，治疗急性重症哮喘是儿科医生经常面临的问题。本文总结了儿童急性重症哮喘的病理生理学和治疗指南。儿童急性哮喘管理的基石是快速给氧、吸入支气管扩张剂和全身皮质激素。吸入性支气管扩张剂可包括选择性β2-激动剂、肾上腺素和抗胆碱能药物。在一些特定病例中，还可能需要静脉内给予茶碱、β2-激动剂和硫酸镁。当药物治疗不能预防呼吸衰竭时，可选择无创或有创通气。重要的是，要制定相关的治疗方案，适用于治疗链的各个环节，并反映当地的考虑因素和情况。
