Linee guida
La gestione dell’accesso asmatico acuto in Pronto Soccorso (e non solo)
Management of acute asthma in children
Giorgio Longo1, Massimo Maschio2, Elisa Panontin1,2, Federico Marchetti3, Giuseppe Furcolo4, Flavio Quarantiello5
1Universitŕ di Trieste; 2IRCCS Materno-Infantile “Burlo-Garofolo”, Trieste; 3UOC di Pediatria e Neonatologia, Ospedale di Ravenna 4Ospedale “Sacro Cuore di Gesů” Fatebenefratelli, Benevento; 5Ospedale AORN “G. Rummo”, Benevento
Novembre 2014 - pagg. 563 -569
Abstract
The management of acute asthma, as a medical emergency, must be organized in advance
by providing materials and tools for an immediate and easy use, especially when the physician
who runs the emergency has limited experience in children. Similarly then, the decision
about children’s destiny (which means discharge, observation or hospitalization) must be taken
with lucidity and awareness. In an emergency/urgency situation guidelines and handbooks
consultation is often difficult and time consuming: it was therefore decided to produce
three concise flow charts (one for each severity degree of acute asthma attack) that arise from
the summary of easier and clearer schedules and steps of the main guidelines available today
(BTS-SIGN, GINA, NAEPP and SIP-Italian guidelines). Explanation notes and comments
for a better comprehension of some passages are also provided.
Classificazione MeSH
Contenuto riservato
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Bibliografia
1. British Thoracic Society Scottish Intercollegiate
Guidelines Network. British Guideline
on the Management of Asthma. Thorax
2008;63 Suppl 4:iv1-121. Revised 2011.
2. Global Initiative for Asthma (GINA). Global
strategy for asthma management and prevention.
Revised 2014.
3. National Asthma Education and Prevention
Program (NAEPP) Guidelines. Managing
Exacerbations of Asthma, 2007:395-7.
4. Indinnimeo L, Barbato A, Cutrera R, et al.
Linee Guida SIP: gestione dell’attacco acuto
d’asma in etŕ pediatrica. Area Pediatrica
2008;5:13-24.
5. Barbi E, Petaros P, Badina L, Longo G. L’accesso
asmatico acuto: meccanismi fisiopatologici,
strumenti diagnostici e i perché dei segni
e sintomi clinici. Medico e Bambino 2005;
24(2):99-103.
6. Gorelich MH, Stevens MW, Schultz T, Scribano
PV. Difficulty in obtaining peack expiratory
flow measurement in children with
acute asthma. Pediatr Emerg Care 2004;20
(1):22-6.
7. Kelly AM, Kerr D, Powell C. Is severity assessment
after one hour of treatment better
for predicting the need for admission in acute
asthma? Respir Med 2004;98(8):777-81.
8. Maglietta V. Diagnosi e terapia pediatrica
pratica. Casa Editrice Ambrosiana, 10a edizione,
2011.
9. Katz WK, Kelly HW, Crowley MR, Grad R,
McWilliams BC, Murphy SJ. Safety of continuous
nebulized albuterol for bronchospasm
in infants and children. Pediatrics 1993;92:
666-9.
10. Robertson CF, Smith F, Beck R, Levison
H. Responses to frequent low-doses of nebulized
salbutamol in acute asthma. J Pediatr
1985;106:672-4.
11. Teoh L, Cates CJ, Hurwitz M, Aeworth JP,
van Asperen P, Chang AB. Anticholinergic
therapy for acute asthma in children. Cochrane
Database Syst Rev 2012;4:CD003797.
12. Travers A, Jones AP, Kelly KD, Barker SJ,
Camargo CA Jr, Rowe BH. Intravenous beta2-
agonists for acute asthma in the emergency
department. Cochrane Database Syst Rev
2001;(2):CD002988.
13. Barbi E, Petaros P, Lenhardt A, Longo G.
Salbutamolo e cortisonici nell’accesso acuto
d’asma: tutto scontato ma non troppo. Medico
e Bambino 2004;23:559-65.
14. Browne GJ, Penna AS, Phung X, Soo M.
Randomised trial of intravenous salbutamol
in early management of acute severe asthma
in children. Lancet 1997;349:301-5.
15. Nair P, Milan SJ, Rowe BH. Addition of intravenous
aminophylline to beta2-agonist in
adults with acute asthma. Cochrane Database
Syst Rev 2012;4:CD002742.
16. Mitra A, Bassler D, Goodman K, Lasserson
TJ, Ducharme FM. Intravenous aminophylline
for acute severe asthma in children
over two years receiving inhaled bronchodilators.
Cochrane Database Syst Rev
2005;2:CD001276.
17. Cheuk DK, Chau TC, Lee SL. A metaanalysis
on intravenous magnesium sulphate
for treating acute asthma. Arch Dis Child
2005;90(1):74-7.
18. Porter RS, Nester, Braitman LE, Geary U,
Dalsey WC. Intravenous magnesium is ineffective
in adult asthma: a randomised trial.
Eur J Emerg Med 2001;8(1):9-15.
19. Silverman RA, Osborn H, Runge J, et al.
Acute Asthma/Magnesium Study Group. IV
magnesium sulphate in the treatment of acute
severe asthma: a multicenter randomized
controlled trial. Chest 2002;122(2):489-97.
20. Petaros P, Salierno P, Rabach I, Barbi E,
Longo G. L’ossigenoterapia: indicazioni, vie
di somministrazione e parametri da valutare.
Medico e Bambino 2007;26(5):291-7.
Corrispondenza: asilepan@yahoo.it