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* From the Departamento de Emergencia (Dr. G. Rodrigo), Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay; the Unidad de Cuidados Intensivos (Dr. C. Rodrigo), Asociación Española 1a de Socorros Mutuos, Montevideo, Uruguay; and Section of Pulmonary and Critical Care Medicine (Dr. Hall), University of Chicago, Chicago, IL.
Correspondence to: Gustavo J. Rodrigo, MD, Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Av. 8 de Octubre 3020, Montevideo 11600, Uruguay; e-mail: gurodrig{at}adinet.com.uy
All patients with asthma are at risk of having exacerbations. Hospitalizations and emergency department (ED) visits account for a large proportion of the health-care cost burden of asthma, and avoidance or proper management of acute asthma (AA) episodes represent an area with the potential for large reductions in health-care costs. The severity of exacerbations may range from mild to life threatening, and mortality is most often associated with failure to appreciate the severity of the exacerbation, resulting in inadequate emergency treatment and delay in referring to hospital. This review describes the epidemiology, costs, pathophysiology, mortality, and management of adult AA in the ED and in the ICU.
Key Words: acute asthma • anticholinergics • assessment • ß-agonists • corticosteroids • heliox • inhalation therapy • magnesium sulfate • mechanical ventilation • oxygen
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