DIAGNOSIS AND TREATMENT: ADVANCES IN THE MANAGEMENT OF STATUS ASTHMATICUS IN CHILDREN

Status asthmaticus in infants and children is associated with increased work of breathing, arterial hypoxemia, and metabolic and respiratory acidosis. Humidified oxygen, intravenous fluids with glucose, intravenous sodium bicarbonate, and light sedation with chloral hydrate sustain the patient in nearly every case until the bronchomotor response to epinephrine returns. A limited number of patients develop respiratory failure characterized by severe respiratory acidosis and hypoxemia that lead to coma and circulatory arrest. By careful clinical observation and serial arterial pH and blood gas measurements, respiratory failure can be diagnosed and treated effectively with mechanical ventilation and intensive respiratory care for the 20 to 30 hours which may elapse before recovery begins.