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Minerva Medica 2021 Feb 26

DOI: 10.23736/S0026-4806.21.07372-9

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Acute severe asthma: management and treatment

Annamaria BOSI 1, Roberto TONELLI 1, 2, Ivana CASTANIERE 1, 2, Enrico CLINI 1, Bianca BEGHÈ 1

1 Respiratory Diseases Unit, University Hospital of Modena, Modena, Italy; 2 Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Modena, Italy


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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 aim 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.


KEY WORDS: Respiratory failure; Dyspnoea; Severe asthma; Acute asthma attack; Near fatal asthma; Asthma management; Asthma treatment; Non-invasive mechanical ventilation

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