Acute Asthma in Adults: Controversies and Best Practice

Acute Asthma in Adults: Controversies and Best Practice

Abstract

Asthma in the emergency care setting is common and may be life-threatening. Last year the British Thoracic Society updated their guidelines for the management of asthma, however some treatments remain controversial and there is variation in adherence to these and other national and international guidelines.
[download-attachments container="div" style="list" dipslay_icon="1" display_count="1" display__size="0"]

References

  1. Masoli M, Fabian D, Holt S, Beasley R. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy. 2004; 59(5): 469–78.
  2. Beasley R. The Global Burden of Asthma Report, Global Initiative for Asthma (GINA). 2004.
  3. Yan DC, Ou LS, Tsai TL, et al. Prevalence and severity of symptoms of asthma, rhinitis, and eczema in 13- to 14-year-old children in Taipei, Taiwan. Ann Allergy Asthma Immunol. 2005; 95(6): 579–85.
  4. Ko FW, Wang HY, Wong GW, et al. Wheezing in Chinese schoolchildren: disease severity distribution and management practices, a community based study in Hong Kong and Guangzhou. Clin Exp Allergy. 2005; 35(11): 1449–56.
  5. Carvajal-Uruena I, Garcia-Marcos L, Busquets-Monge R, et al. [Geographic variation in the prevalence of asthma symptoms in Spanish children and adolescents. International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3, Spain]. Arch Bronconeumol. 2005; 41(12): 659–66.
  6. BTS. The burden of lung disease: a statistical report from the British Thoracic Society. 2nd ed. London: British Thoracic Society, 2006.
  7. European lung white book. Brussels, Belgium: Europe: European Respiratory Society and the European Lung Foundation., 2003.
  8. BTS. British guideline on the management of asthma. Thorax 2009; 63(Suppl iv): iv1–iv121.
  9. NICE. National Clinical Guideline on management of chronic obstructive pulmonary disease in adults in primary and secondary care. Thorax 2004; 59(Suppl I): 1–232.
  10. Weber EJ, Silverman RA, Callaham ML, et al. A prospective multicenter study of factors associated with hospital admission among adults with acute asthma. Am J Med. 2002; 113(5): 371–8.
  11. McFadden ER, Jr., Lyons HA. Arterial-blood gas tension in asthma. N Engl J Med. 1968; 278(19): 1027–32.
  12. Rebuck AS, Read J. Assessment and management of severe asthma. Am J Med. 1971; 51(6): 788–98.
  13. Group BTSEOG. Guideline for emergency oxygen use in adult patients. Thorax 2009; 63(Suppl VI): vi1–vi68.
  14. Camargo CA, Jr., Spooner CH, Rowe BH. Continuous versus intermittent beta-agonists in the treatment of acute asthma. Cochrane Database Syst Rev 2003; 4.
  15. Lanes SF, Garrett JE, Wentworth CE, et al. The effect of adding ipratropium bromide to salbutamol in the treatment of acute asthma: a pooled analysis of three trials. Chest. 1998; 114(2): 365–72.
  16. Rodrigo G, Rodrigo C, Burschtin O. A meta-analysis of the effects of ipratropium bromide in adults with acute asthma. Am J Med. 1999; 107(4): 363–70.
  17. Stoodley RG, Aaron SD, Dales RE. The role of ipratropium bromide in the emergency management of acute asthma exacerbation: a metaanalysis of randomized clinical trials. Ann Emerg Med. 1999; 34(1): 8–18.
  18. Global Strategy for Asthma Management and Prevention. NHLBI / WHO Workshop Report 2005;NIH Publication No. 02-3659.
  19. Travers AH, Rowe BH, Barker S, et al. The effectiveness of IV beta-agonists in treating patients with acute asthma in the emergency department: a meta-analysis. Chest. 2002; 122(4): 1200–7.
  20. Rowe BH, Spooner C, Ducharme FM, et al. Early emergency department treatment of acute asthma with systemic corticosteroids. Cochrane Database Syst Rev 2001; 1.
  21. Rowe BH, Spooner CH, Ducharme FM, et al. Corticosteroids for preventing relapse following acute exacerbations of asthma. Cochrane Database Syst Rev 2001; 1.
  22. FitzGerald JM, Becker A, Sears MR, et al. Doubling the dose of budesonide versus maintenance treatment in asthma exacerbations. Thorax. 2004; 59(7): 550–6.
  23. Harrison TW, Oborne J, Newton S, Tattersfield AE. Doubling the dose of inhaled corticosteroid to prevent asthma exacerbations: randomised controlled trial. Lancet. 2004; 363(9405): 271–5.
  24. Rice-McDonald G, Bowler S, Staines G, Mitchell C. Doubling daily inhaled corticosteroid dose is ineffective in mild to moderately severe attacks of asthma in adults. Intern Med J. 2005; 35(12): 693–8.
  25. Littenberg B. Aminophylline treatment in severe, acute asthma. A metaanalysis. Jama. 1988; 259(11): 1678–84.
  26. Parameswaran K, Belda J, Rowe BH. Addition of intravenous aminophylline to beta2-agonists in adults with acute asthma. Cochrane Database Syst Rev 2000;4.
  27. Okayama H, Aikawa T, Okayama M, et al. Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma. Jama. 1987; 257(8): 1076–8.
  28. Rolla G, Bucca C, Caria E, et al. Acute effect of intravenous magnesium sulfate on airway obstruction of asthmatic patients. Ann Allergy. 1988; 61(5): 388–91.
  29. Rowe BH, Bretzlaff JA, Bourdon C, et al. Magnesium sulfate for treating exacerbations of acute asthma in the emergency department. Cochrane Database Syst Rev 2000; 2.
  30. NHLBI. Guidelines for the Diagnosis and Management of Asthma: NHLBI, 2007.
  31. Intravenous magnesium for acute asthma? Drug Ther Bull. 2003; 41(10): 79–80.
  32. Blitz M, Blitz S, Beasely R, et al. Inhaled magnesium sulfate in the treatment of acute asthma. Cochrane Database Syst Rev. 2005(4): CD003898.
  33. Soroksky A, Stav D, Shpirer I. A pilot prospective, randomized, placebocontrolled trial of bilevel positive airway pressure in acute asthmatic attack. Chest. 2003; 123(4): 1018–25.
  34. Rodrigo G, Pollack C, Rodrigo C, Rowe BH. Heliox for nonintubated acute asthma patients. Cochrane Database Syst Rev. 2006(4): CD002884.
  35. Friedlander SL, Busse WW. The role of rhinovirus in asthma exacerbations. J Allergy Clin Immunol. 2005; 116(2): 267–73.
  36. Johnston SL, Blasi F, Black PN, et al. The effect of telithromycin in acute exacerbations of asthma. N Engl J Med. 2006; 354(15): 1589–600.
  37. Pearson M, Ryland I, Harrison B. National audit of acute severe asthma in adults admitted to hospital. Standards of Care Committee, British Thoracic Society. Qual Health Care 1995; 4(1): 24–30.
  38. McFadden ER, Jr., Elsanadi N, Dixon L, et al. Protocol therapy for acute asthma: therapeutic benefits and cost savings. Am J Med. 1995; 99(6): 651–61.
  39. Goldberg R, Chan L, Haley P, et al. Critical pathway for the emergency department management of acute asthma: effect on resource utilization. Ann Emerg Med. 1998; 31(5): 562–7.
  40. Cowie RL, Revitt SG, Underwood MF, Field SK. The effect of a peak flow-based action plan in the prevention of exacerbations of asthma. Chest. 1997; 112(6): 1534–8.

Request Permissions

To request copyright permission to republish or share portions of our works, please visit Copyright Clearance Center’s (CCC) Marketplace website by clicking the button below:

Get Permission

Acute Asthma in Adults: Controversies and Best Practice

2nd March 2016
PMID: 21607203
Authors Affiliations
Maren Schuhmann MRCP Specialist Registrar in Respiratory & GIM Respiratory Department, Queen Alexandra Hospital, Portsmouth, UK
Fraser Brims MRCP MD Specialist Registrar in Respiratory & GIM Respiratory Department, Queen Alexandra Hospital, Portsmouth, UK
Anoop J Chauhan Respiratory Centre Queen Alexandra Hospital PO6 3LY Portsmouth, UK Email: anoop.chauhan@ porthosp.nhs.uk

Acute Asthma in Adults: Controversies and Best Practice

Cite this article as:


Acute Asthma in Adults: Controversies and Best Practice

Share this article

Click the icon of the social media platform on which you would like to share this article.


Shopping Basket
Scroll to Top