Status Asthmaticus Guidelines

1. Rice JL, Matlack KM, Simmons MD, Steinfeld J, Laws MA, Dovey ME, et al. LEAP: A randomized-controlled trial of a lay-educator inpatient asthma education program. Patient Educ Couns. 2015 Jun 29. [QxMD MEDLINE Link].

2. Han P, Cole RP. Evolving differences in the presentation of severe asthma requiring intensive care unit admission. Respiration. 2004 Sep-Oct. 71(5):458-62. [QxMD MEDLINE Link].

3. Vaschetto R, Bellotti E, Turucz E, Gregoretti C, Corte FD, Navalesi P. Inhalational anesthetics in acute severe asthma. Curr Drug Targets. 2009 Sep. 10(9):826-32. [QxMD MEDLINE Link].

4. Hanania NA, David-Wang A, Kesten S, Chapman KR. Factors associated with emergency department dependence of patients with asthma. Chest. 1997 Feb. 111(2):290-5. [QxMD MEDLINE Link].

5. Vital Signs: Asthma Prevalence, Disease Characteristics, and Self-Management Education --- United States, 2001—2009. CDC MMWR. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6017a4.htm?s_cid=mm6017a4_w. Accessed: August 20, 2014.

6. Graudenz GS, Carneiro DP, Vieira RP. Trends in asthma mortality in the 0- to 4-year and 5- to 34-year age groups in Brazil. J Bras Pneumol. 2017 Jan-Feb. 43 (1):24-31. [QxMD MEDLINE Link].

7. O'Hollaren MT, Yunginger JW, Offord KP, Somers MJ, O'Connell EJ, Ballard DJ, et al. Exposure to an aeroallergen as a possible precipitating factor in respiratory arrest in young patients with asthma. N Engl J Med. 1991 Feb 7. 324 (6):359-63. [QxMD MEDLINE Link].

8. [Guideline] Dinakar C, Oppenheimer J, Portnoy J, et al. Management of acute loss of asthma control in the yellow zone: a practice parameter. Ann Allergy Asthma Immunol. 2014 Aug. 113 (2):143-59. [QxMD MEDLINE Link].

9. Magadle R, Berar-Yanay N, Weiner P. The risk of hospitalization and near-fatal and fatal asthma in relation to the perception of dyspnea. Chest. 2002 Feb. 121 (2):329-33. [QxMD MEDLINE Link].

10. Summers RL, Rodriguez M, Woodward LA, Galli RL, Causey AL. Effect of nebulized albuterol on circulating leukocyte counts in normal subjects. Respir Med. 1999 Mar. 93 (3):180-2. [QxMD MEDLINE Link].

11. Samraj RS, Crotty EJ, Wheeler DS. Procalcitonin Levels in Critically Ill Children With Status Asthmaticus. Pediatr Emerg Care. 2019 Oct. 35 (10):671-674. [QxMD MEDLINE Link].

12. Hunt SN, Jusko WJ, Yurchak AM. Effect of smoking on theophylline disposition. Clin Pharmacol Ther. 1976 May. 19 (5 Pt 1):546-51. [QxMD MEDLINE Link].

13. [Guideline] National Heart, Lung, and Blood Institute. Managing exacerbations of asthma. National Asthma Education and Prevention Program (NAEPP). Expert panel report 3: guidelines for the diagnosis and management of asthma. National Guideline Clearinghouse; [Full Text].

14. Saadeh CK, Goldman MD, Gaylor PB. Forced oscillation using impulse oscillometry (IOS) detects false negative spirometry in symptomatic patients with reactive airways. J Allergy Clin Immunol. 2003. 111:S136.

15. Schultz TE. Sevoflurane administration in status asthmaticus: a case report. AANA J. 2005 Feb. 73(1):35-6. [QxMD MEDLINE Link].

16. Fuller CG, Schoettler JJ, Gilsanz V, Nelson MD Jr, Church JA, Richards W. Sinusitis in status asthmaticus. Clin Pediatr (Phila). 1994 Dec. 33(12):712-9. [QxMD MEDLINE Link].

17. Sacha RF, Tremblay NF, Jacobs RL. Chronic cough, sinusitis, and hyperreactive airways in children: an often overlooked association. Ann Allergy. 1985 Mar. 54(3):195-8. [QxMD MEDLINE Link].

18. Schwartz HJ, Thompson JS, Sher TH, Ross RJ. Occult sinus abnormalities in the asthmatic patient. Arch Intern Med. 1987 Dec. 147(12):2194-6. [QxMD MEDLINE Link].

19. Dockhorn RJ, Baumgartner RA, Leff JA, Noonan M, Vandormael K, Stricker W, et al. Comparison of the effects of intravenous and oral montelukast on airway function: a double blind, placebo controlled, three period, crossover study in asthmatic patients. Thorax. 2000 Apr. 55 (4):260-5. [QxMD MEDLINE Link].

20. Camargo CA Jr, Smithline HA, Malice MP, Green SA, Reiss TF. A randomized controlled trial of intravenous montelukast in acute asthma. Am J Respir Crit Care Med. 2003 Feb 15. 167 (4):528-33. [QxMD MEDLINE Link].

21. Ferreira MB, Santos AS, Pregal AL, Michelena T, Alonso E, de Sousa AV, et al. Leukotriene receptor antagonists (Montelukast) in the treatment of asthma crisis: preliminary results of a double-blind placebo controlled randomized study. Allerg Immunol (Paris). 2001 Oct. 33 (8):315-8. [QxMD MEDLINE Link].

22. Khedher A, Meddeb K, Sma N, Azouzi A, Fraj N, Boussarsar M. Pulmonary Barotrauma Including Huge Pulmonary Interstitial Emphysema in an Adult with Status Asthmaticus: Diagnostic and Therapeutic Challenges. Eur J Case Rep Intern Med. 2018. 5 (5):000823. [QxMD MEDLINE Link].

23. Andrews T, McGintee E, Mittal MK, et al. High-dose continuous nebulized levalbuterol for pediatric status asthmaticus: a randomized trial. J Pediatr. 2009 Aug. 155(2):205-10.e1. [QxMD MEDLINE Link].

24. Best evidence topic reports. Bet 3. Endotracheal adrenaline in intubated patients with asthma. Emerg Med J. 2009 May. 26(5):359. [QxMD MEDLINE Link].

25. Beach C, Marcuccio E, Beerman L, Arora G. Accelerated Idioventricular Rhythm in a Child With Status Asthmaticus. Pediatrics. 2015 Aug. 136 (2):e527-9. [QxMD MEDLINE Link].

26. Stephanopoulos DE, Monge R, Schell KH, Wyckoff P, Peterson BM. Continuous intravenous terbutaline for pediatric status asthmaticus. Crit Care Med. 1998 Oct. 26(10):1744-8. [QxMD MEDLINE Link].

27. Newman LJ, Richards W, Church JA. Isoetharine-isoproterenol: a comparison of effects in childhood status asthmaticus. Ann Allergy. 1982 Apr. 48(4):230-2. [QxMD MEDLINE Link].

28. Chiang VW, Burns JP, Rifai N, Lipshultz SE, Adams MJ, Weiner DL. Cardiac toxicity of intravenous terbutaline for the treatment of severe asthma in children: a prospective assessment. J Pediatr. 2000 Jul. 137(1):73-7. [QxMD MEDLINE Link].

29. Kalyanaraman M, Bhalala U, Leoncio M. Serial cardiac troponin concentrations as marker of cardiac toxicity in children with status asthmaticus treated with intravenous terbutaline. Pediatr Emerg Care. 2011 Oct. 27(10):933-6. [QxMD MEDLINE Link].

30. Castro-Rodriguez JA, Rodrigo GJ. Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Pediatrics. 2009 Mar. 123(3):e519-25. [QxMD MEDLINE Link].

31. Haskell RJ, Wong BM, Hansen JE. A double-blind, randomized clinical trial of methylprednisolone in status asthmaticus. Arch Intern Med. 1983 Jul. 143(7):1324-7. [QxMD MEDLINE Link].

32. Sochet AA, Son S, Ryan KS, Roddy M, Barrie E, Wilsey M, et al. Stress ulcer prophylaxis in children with status asthmaticus receiving systemic corticosteroids: a descriptive study assessing frequency of clinically important bleeding. J Asthma. 2019 May 30. 1-8. [QxMD MEDLINE Link].

33. Ream RS, Loftis LL, Albers GM, Becker BA, Lynch RE, Mink RB. Efficacy of IV theophylline in children with severe status asthmaticus. Chest. 2001 May. 119(5):1480-8. [QxMD MEDLINE Link]. [Full Text].

34. Wheeler DS, Jacobs BR, Kenreigh CA, Bean JA, Hutson TK, Brilli RJ. Theophylline versus terbutaline in treating critically ill children with status asthmaticus: a prospective, randomized, controlled trial. Pediatr Crit Care Med. 2005 Mar. 6(2):142-7. [QxMD MEDLINE Link].

35. Press S, Lipkind RS. A treatment protocol of the acute asthma patient in a pediatric emergency department. Clin Pediatr (Phila). 1991 Oct. 30(10):573-7. [QxMD MEDLINE Link].

36. Ciarallo L, Brousseau D, Reinert S. Higher-dose intravenous magnesium therapy for children with moderate to severe acute asthma. Arch Pediatr Adolesc Med. 2000 Oct. 154(10):979-83. [QxMD MEDLINE Link].

37. Glover ML, Machado C, Totapally BR. Magnesium sulfate administered via continuous intravenous infusion in pediatric patients with refractory wheezing. J Crit Care. 2002 Dec. 17(4):255-8. [QxMD MEDLINE Link].

38. Scarfone RJ, Loiselle JM, Joffe MD, Mull CC, Stiller S, Thompson K, et al. A randomized trial of magnesium in the emergency department treatment of children with asthma. Ann Emerg Med. 2000 Dec. 36(6):572-8. [QxMD MEDLINE Link].

39. Bessmertny O, DiGregorio RV, Cohen H, et al. A randomized clinical trial of nebulized magnesium sulfate in addition to albuterol in the treatment of acute mild-to-moderate asthma exacerbations in adults. Ann Emerg Med. 2002 Jun. 39(6):585-91. [QxMD MEDLINE Link].

40. Vaiyani D, Irazuzta JE. Comparison of Two High-Dose Magnesium Infusion Regimens in the Treatment of Status Asthmaticus. J Pediatr Pharmacol Ther. 2016 May-Jun. 21 (3):233-8. [QxMD MEDLINE Link].

41. Graff DM, Stevenson MD, Berkenbosch JW. Safety of prolonged magnesium sulfate infusions during treatment for severe pediatric status asthmaticus. Pediatr Pulmonol. 2019 Dec. 54 (12):1941-1947. [QxMD MEDLINE Link].

42. Heshmati F, Zeinali MB, Noroozinia H, Abbacivash R, Mahoori A. Use of ketamine in severe status asthmaticus in intensive care unit. Iran J Allergy Asthma Immunol. 2003 Dec. 2(4):175-80. [QxMD MEDLINE Link].

43. Golding CL, Miller JL, Gessouroun MR, Johnson PN. Ketamine Continuous Infusions in Critically Ill Infants and Children. Ann Pharmacother. 2016 Mar. 50 (3):234-41. [QxMD MEDLINE Link].

44. Keenan LM, Hoffman TL. Refractory Status Asthmaticus: Treatment With Sevoflurane. Fed Pract. 2019 Oct. 36 (10):476-479. [QxMD MEDLINE Link].

45. Vohra R, Sachdev A, Gupta D, Gupta N, Gupta S. Refractory Status Asthmaticus: A Case for Unconventional Therapies. Indian J Crit Care Med. 2018 Oct. 22 (10):749-752. [QxMD MEDLINE Link].

46. Elliot S, Berridge JC, Mallick A. Use of the AnaConDa anaesthetic delivery system in ICU. Anaesthesia. 2007 Jul. 62(7):752-3. [QxMD MEDLINE Link].

47. Burburan SM, Xisto DG, Rocco PR. Anaesthetic management in asthma. Minerva Anestesiol. 2007 Jun. 73(6):357-65. [QxMD MEDLINE Link].

48. Tobias JD. Inhalational anesthesia: basic pharmacology, end organ effects, and applications in the treatment of status asthmaticus. J Intensive Care Med. 2009 Nov-Dec. 24(6):361-71. [QxMD MEDLINE Link].

49. Rishani R, El-Khatib M, Mroueh S. Treatment of severe status asthmaticus with nitric oxide. Pediatr Pulmonol. 1999 Dec. 28(6):451-3. [QxMD MEDLINE Link].

50. Mroueh S. Inhaled nitric oxide for acute asthma. J Pediatr. 2006 Jul. 149(1):145; author reply 145. [QxMD MEDLINE Link].

51. Hunt LW, Frigas E, Butterfield JH, Kita H, Blomgren J, Dunnette SL, et al. Treatment of asthma with nebulized lidocaine: a randomized, placebo-controlled study. J Allergy Clin Immunol. 2004 May. 113 (5):853-9. [QxMD MEDLINE Link].

52. Schulz O, Wiesner O, Welte T, Bollmann BA, Suhling H, Hoeper MM, et al. Enoximone in status asthmaticus. ERJ Open Res. 2020 Jan. 6 (1):[QxMD MEDLINE Link].

53. Mikkelsen ME, Pugh ME, Hansen-Flaschen JH, Woo YJ, Sager JS. Emergency extracorporeal life support for asphyxic status asthmaticus. Respir Care. 2007 Nov. 52(11):1525-9. [QxMD MEDLINE Link].

54. Coleman NE, Dalton HJ. Extracorporeal life support for status asthmaticus: the breath of life that's often forgotten. Crit Care. 2009. 13(2):136. [QxMD MEDLINE Link]. [Full Text].

55. Hebbar KB, Petrillo-Albarano T, Coto-Puckett W, Heard M, Rycus PT, Fortenberry JD. Experience with use of extracorporeal life support for severe refractory status asthmaticus in children. Crit Care. 2009. 13(2):R29. [QxMD MEDLINE Link]. [Full Text].

56. Noizet-Yverneau O, Leclerc F, Bednarek N, et al. [Noninvasive mechanical ventilation in paediatric intensive care units: which indications in 2010?]. Ann Fr Anesth Reanim. 2010 Mar. 29(3):227-32. [QxMD MEDLINE Link].

57. Ram FS, Wellington S, Rowe BH, Wedzicha JA. Non-invasive positive pressure ventilation for treatment of respiratory failure due to severe acute exacerbations of asthma. Cochrane Database Syst Rev. 2005 Jan 25. CD004360. [QxMD MEDLINE Link].

58. Ueda T, Tabuena R, Matsumoto H, Takemura M, Niimi A, Chin K, et al. Successful weaning using noninvasive positive pressure ventilation in a patient with status asthmaticus. Intern Med. 2004 Nov. 43(11):1060-2. [QxMD MEDLINE Link].

59. Steinack C, Lenherr R, Hendra H, Franzen D. The use of life-saving extracorporeal membrane oxygenation (ECMO) for pregnant woman with status asthmaticus. J Asthma. 2016 Jun 24. 1-5. [QxMD MEDLINE Link].

60. Niimi KS, Lewis LS, Fanning JJ. Impairment of Venous Drainage on Extracorporeal Membrane Oxygenation Secondary to Air Trapping in Acute Asphyxial Asthma. J Extra Corpor Technol. 2015 Jun. 47 (2):109-12. [QxMD MEDLINE Link].

61. Leatherman JW, McArthur C, Shapiro RS. Effect of prolongation of expiratory time on dynamic hyperinflation in mechanically ventilated patients with severe asthma. Crit Care Med. 2004 Jul. 32(7):1542-5. [QxMD MEDLINE Link].

62. Silva Pde S, Barreto SS. Noninvasive ventilation in status asthmaticus in children: levels of evidence. Rev Bras Ter Intensiva. 2015 Oct-Dec. 27 (4):390-6. [QxMD MEDLINE Link].

63. Rampa S, Allareddy V, Asad R, Nalliah RP, Allareddy V, Rotta AT. outcome of invasive mechanical ventilation in children and adolescents hospitalized due to status asthmaticus in the United States: A population based study. J Emerg Med. vovember 2014. 47:571-2.

64. González García L, Rey C, Medina A, Mayordomo-Colunga J. Severe subcutaneous emphysema and pneumomediastinum secondary to noninvasive ventilation support in status asthmaticus. Indian J Crit Care Med. 2016 Apr. 20 (4):242-4. [QxMD MEDLINE Link].

65. Ricketti PA, Unkle DW, Lockey R, Cleri DJ, Ricketti AJ. Case study: Idiopathic hemothorax in a patient with status asthmaticus. J Asthma. 2016 Sep. 53 (7):770-3. [QxMD MEDLINE Link].

66. Shiue ST, Gluck EH. The use of helium-oxygen mixtures in the support of patients with status asthmaticus and respiratory acidosis. J Asthma. 1989. 26(3):177-80. [QxMD MEDLINE Link].

67. Kim IK, Phrampus E, Venkataraman S, Pitetti R, et al. Helium/oxygen-driven albuterol nebulization in the treatment of children with moderate to severe asthma exacerbations: a randomized, controlled trial. Pediatrics. 2005 Nov. 116(5):1127-33. [QxMD MEDLINE Link].

68. Kudukis TM, Manthous CA, Schmidt GA, Hall JB, Wylam ME. Inhaled helium-oxygen revisited: effect of inhaled helium-oxygen during the treatment of status asthmaticus in children. J Pediatr. 1997 Feb. 130(2):217-24. [QxMD MEDLINE Link].

69. Anderson M, Svartengren M, Bylin G, Philipson K, Camner P. Deposition in asthmatics of particles inhaled in air or in helium-oxygen. Am Rev Respir Dis. 1993 Mar. 147(3):524-8. [QxMD MEDLINE Link].

70. Carvalho I, Querido S, Silvestre J, Póvoa P. Heliox in the treatment of status asthmaticus: case reports. Rev Bras Ter Intensiva. 2016 Jan-Mar. 28 (1):87-91. [QxMD MEDLINE Link].

71. Oguzulgen IK, Turktas H, Mullaoglu S, Ozkan S. What can predict the exacerbation severity in asthma?. Allergy Asthma Proc. 2007 May-Jun. 28(3):344-7. [QxMD MEDLINE Link].

72. Miller AG, Breslin ME, Pineda LC, Fox JW. An Asthma Protocol Improved Adherence to Evidence-Based Guidelines for Pediatric Subjects With Status Asthmaticus in the Emergency Department. Respir Care. 2015 Dec. 60 (12):1759-64. [QxMD MEDLINE Link].

73. Khawaja A, Shahzad H, Kazmi M, Zubairi AB. Clinical course and outcome of acute severe asthma (status asthmaticus) in adults. J Pak Med Assoc. 2014 Nov. 64 (11):1292-6. [QxMD MEDLINE Link].

74. Phumeetham S, Bahk TJ, Abd-Allah S, Mathur M. Effect of high-dose continuous albuterol nebulization on clinical variables in children with status asthmaticus. Pediatr Crit Care Med. 2015 Feb. 16 (2):e41-6. [QxMD MEDLINE Link].

75. Beute J. Emergency treatment of status asthmaticus with enoximone. Br J Anaesth. 2014 Jun. 112 (6):1105-8. [QxMD MEDLINE Link].

Constantine K Saadeh, MD President, Allergy ARTS, LLP; Principal Investigator, Amarillo Center for Clinical Research, Ltd

Constantine K Saadeh, MD is a member of the following medical societies: American Academy of Allergy, Asthma and Immunology, American College of Rheumatology, American Medical Association, Southern Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

John J Oppenheimer, MD Clinical Professor, Department of Medicine, Rutgers New Jersey Medical School; Director of Clinical Research, Pulmonary and Allergy Associates, PA

John J Oppenheimer, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Allergy, Asthma and Immunology, New Jersey Allergy, Asthma and Immunology Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Amgen; GSK; Aquestive; Aimmune<br/>Clinical Adjudication/Data Safety Monitoring Board for AZ, GSK, Abbvie, Sanofi; Executive Editor for Annals of Allergy, Asthma & Immunology; Editor for Medscape; Reviewer for UpToDate; Honoraria from American Board of Allergy and Immunology.

Michael R Bye, MD Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

G Patricia Cantwell, MD, FCCM Professor of Clinical Pediatrics, Chief, Division of Pediatric Critical Care Medicine, University of Miami, Leonard M Miller School of Medicine; Medical Director, Palliative Care Team, Director, Pediatric Critical Care Transport, Holtz Children's Hospital, Jackson Memorial Medical Center; Medical Manager, FEMA, Urban Search and Rescue, South Florida, Task Force 2; Pediatric Medical Director, Tilli Kids – Pediatric Initiative, Division of Hospice Care Southeast Florida, Inc

G Patricia Cantwell, MD, FCCM is a member of the following medical societies: American Academy of Hospice and Palliative Medicine, American Academy of Pediatrics, American Heart Association, American Trauma Society, National Association of EMS Physicians, Society of Critical Care Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Barry J Evans, MD Assistant Professor of Pediatrics, Temple University Medical School; Director of Pediatric Critical Care and Pulmonology, Associate Chair for Pediatric Education, Temple University Children's Medical Center

Barry J Evans, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Michael Goldman Professor of Internal Medicine, University of California, Los Angeles, David Geffen School of Medicine

Disclosure: Nothing to disclose.

Helen M Hollingsworth, MD Director, Adult Asthma and Allergy Services, Associate Professor, Department of Internal Medicine, Division of Pulmonary and Critical Care, Boston Medical Center

Helen M Hollingsworth, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Chest Physicians, American Thoracic Society, and Massachusetts Medical Society

Disclosure: Nothing to disclose.

Jan Malacara, PA-C Consulting Staff, Allergy ARTS, LLP

Disclosure: Nothing to disclose.

Adam J Schwarz, MD Consulting Staff, Critical Care Division, Pediatric Subspecialty Faculty, Children's Hospital of Orange County

Adam J Schwarz, MD is a member of the following medical societies: American Academy of Pediatrics and Phi Beta Kappa

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

What would you like to print?

• Print this section
• Print the entire contents of
• Print the entire contents of article