Critical Issues in the Treatment of Pediatric Status Asthmaticus

Asthma is the most common chronic disease of childhood, and consequently the most frequent cause of hospitalization among children in the United States. Recently, the National Center of Health Statistics reported that in 2009 there was an 8.2% prevalence of asthma in the United States thereby affecting 7.1 million children (0-17 years). Amongst that population, 56.3% (4.0 million) were reported to have an exacerbation. Derivatively, asthma exacerbation can be the source of nearly half a million admissions to pediatric intensive care units each year. For this reason, it is important that all healthcare workers, especially those in the critical care setting, become familiar and stay up to date on current issues involving the treatment, management, and alternative therapies for acute severe asthma exacerbations (i.e., status asthmaticus).


Asthma exacerbations are typically classified as mild, moderate, or severe. An acute severe asthma exacerbation is loosely defined, but relies on presenting signs, symptoms, response to therapy, or a peak flow rate <40 percent of the predicted value for age, sex and height. There are several scoring systems currently employed to help assess asthma severity in children.


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