Pharmacological Management of Pediatric Critical Asthma

Respir Care. 2024 Sep 30:respcare.12458. doi: 10.4187/respcare.12458. Online ahead of print.

Abstract

Pediatric critical asthma, or formerly known as status asthmaticus, is a common pediatric condition encountered in emergency departments, hospital wards, and pediatric intensive care units. Systemic corticosteroids and inhaled bronchodilators are evidence-based, initial treatments for patients with pediatric critical asthma. If clinical symptoms do not improve, pediatric practitioners often prescribe adjunctive medications including inhaled anticholinergics, intravenous ketamine, intravenous magnesium, intravenous short acting beta 2 agonists, and intravenous methylxanthines (such as aminophylline). In this narrative review, we will summarize the current evidence and present the research gaps related to these therapies in the pediatric population.

Keywords: Aminophylline; Bronchodilator Agents; Critical Care; Glucocorticoids; Ketamine; Magnesium; Pediatrics; Status Asthmaticus; Terbutaline.