THE CHILD WITH ASTHMA - EMERGENCY AND CRITICAL CARE ISSUES

Our understanding of the genetics and the pathophysiology of asthma has greatly improved over the past decade. This in addition to recent clinical trials has enabled preventative strategies and earlier therapeutic interventions, leading to a decreased need for paediatric intensive care interventions including mechanical ventilation. Early recognition of disease severity, good supportive care and aggressive use of supplemental oxygen, beta-agonists, anticholinergics and steroids are the mainstay of treatment. Non-conventional therapies such as methylxanthines, magnesium sulphate, ketamine, heliox, adrenaline and anaesthetic agents contribute in varying degrees to treatment in resistant cases. The likelihood of tailored drug therapy bodes well for the future.