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Acute severe asthma

机译：急性重症哮喘

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Acute exacerbations of asthma are very common reasons for a presentation to emergency departments. This paper focuses on defining the high-risk group, consideration of the concept of phenotypes of acute asthma, the assessment of severe and life-threatening exacerbations and an emphasis on the management of the more severe end of the exacerbation severity. A number of evidence-based guidelines exist throughout the world and are all slightly different. This reflects the poor evidence base for some of those recommendations. Thus, a large variation of treatment drugs, doses and regimen are used and clearly not standardised. This paper aims to present a summary of the best evidence and discuss some of these controversies. The most important aspect of treating an exacerbation of acute asthma is to review regularly and assess response to treatment. Severe and life-threatening episodes should be treated with early use of intravenous treatment in a stepwise manner following the local guidelines. Non-invasive ventilation and high flow nasal cannulae delivery of oxygen in the emergency department are evolving modalities, but evidence for their use is currently limited.
机译：向急诊科就诊的哮喘急性发作是非常普遍的原因。本文的重点是确定高危人群，考虑急性哮喘的表型概念，评估严重和危及生命的急性加重，并着重于管理更严重的急性加重期。全世界存在许多基于证据的指南，并且都略有不同。这反映出其中一些建议的证据不足。因此，使用了大量的治疗药物，剂量和方案，并且显然没有标准化。本文旨在提供最佳证据的摘要，并讨论其中一些争议。治疗急性哮喘恶化的最重要方面是定期检查并评估对治疗的反应。严重和危及生命的发作应按照当地指南，以逐步的方式及早使用静脉治疗。急诊科室的无创通气和高流量鼻导管输送氧气正在发展，但目前使用证据有限。

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