Oliva MHOM, Maya BDK, Ochoa MX

Language: Spanish
References: 16
Page: 55-58
PDF size: 203.11 Kb.

ABSTRACT

Asthma is a heterogeneous disease, usually characterized by chronic inflammation of the airways, in which the pathogenesis involves various cells and inflammatory mediators. In the pediatric patient, severe asthma is defined as a crisis that develops in minutes or hours depending on the forced expiratory volume in the first second, speech capacity, heart rate, respiratory rate and the arterial carbon dioxide concentration, and has required treatment with high doses of inhaled corticosteroids, β2 long-acting agonists, leukotriene modifiers, theophylline or systemic corticosteroids in more than half of the previous year. Nearly two million children with acute asthma consult a physician annually, and of these, 20% relapse within the next three weeks and require a new visit to the emergency department; thus, the importance of an early diagnosis and a timely treatment, since this pathology confers significant morbidity and mortality to the children who suffer it. We present a case of a four-year-old patient who arrived in the emergency department with an asthmatic crisis, with partial response to the initial management with β2 agonists, anticholinergics, inhaled and systemic steroids. After inhalotherapy with ipratropium bromide/salbutamol and budesonide delivered with heliox in a 70:30 concentration, she had a favorable evolution and was discharged in 72 hours. In a child with severe asthma, the first step is to confirm the diagnosis and ensure management strategies promptly. There are currently many therapies for the different stages of this disease. The heliox therapy in combination with bronchodilators is effective for the treatment of severe asthma and is associated with a shorter inpatient stay.

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