Acute severe asthma: management and treatment

Minerva Med. 2021 Oct;112(5):605-614. doi: 10.23736/S0026-4806.21.07372-9. Epub 2021 Feb 26.

Abstract

Patients with acute asthma attack usually access the emergency room with severe functional impairment, despite low perception of symptoms. In this scenario, early functional assessment is essential focusing on vital parameters and respiratory function, alongside perceived dyspnea. Impairment of ventilatory mechanics due to progressive dynamic pulmonary hyperinflation should be promptly treated with medical inhalation and/or intravenous therapy, reserving intensive treatment in case of non-response and/or worsening of the clinical conditions. Therapeutic planning at patient's discharge is no less important than treatment management during emergency room access as educating the patient about therapeutic adherence significantly impact long-term outcomes of asthma. With this review we aimed at exploring current evidence on acute asthma attack management, focusing of pharmacological and ventilatory strategies of care and highlighting the importance of patient education once clinical stability allows discharge from the emergency department.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Administration, Inhalation
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / diagnosis
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Bronchodilator Agents / therapeutic use
  • Dyspnea / diagnosis
  • Emergency Service, Hospital*
  • Humans
  • Intermittent Positive-Pressure Breathing
  • Medication Adherence
  • Noninvasive Ventilation
  • Patient Discharge*
  • Patient Education as Topic
  • Respiratory Insufficiency / therapy
  • Respiratory Mechanics
  • Risk Factors
  • Symptom Assessment

Substances

  • Anti-Asthmatic Agents
  • Bronchodilator Agents