SERIOUS ACUTE ASTHMA - CLINICAL AND THERA PEUTIC ASPECTS

Acute asthma remains one of the most frequent respiratory emergencies. Serious acute asthma is defined as a group of life-threatening clinic al situations due to more or less rapid development of respiratory dis tress. The severity of the asthma attack can be rapidly evaluated by s imple clinical criteria, most of which can be identified by inspection of the patient. Their presence indicates the existence of intense bro nchial obstruction for which treatment must be initiated immediately. Treatment is based on first-line use of high-dose inhaled beta-2-mimet ics (nebulization or inhalation chamber). Systemic corticosteroid ther apy does not have an immediate effect, but prevents relapses and must therefore be systematically associated. The presence of severity crite ria requires admission to hospital which must be performed by medicali zed ambulance. Beta-2-mimetics and corticosteroids must be continued d uring admission and possibly reinforced by the addition of anticholine rgic nebulizers. The absence of objective signs of improvement require s transfer to the intensive care unit where intubation and mechanical ventilation must be performed when necessary. Return to normal, or at least optimization of ventilatory function and readjustment of mainten ance treatment must be ensured after any episode of serious acute asth ma.