Pediatric critical asthma, formerly known as status asthmaticus, is a common pediatric condition encountered in emergency departments, hospital wards, and PICUs. Systemic corticosteroids and inhaled bronchodilators are evidence-based, initial treatments for patients with pediatric critical asthma. If clinical symptoms do not improve, then pediatric practitioners often prescribe adjunctive medications, including inhaled anticholinergics, intravenous ketamine, intravenous magnesium, intravenous short-acting β2 agonists, and intravenous methylxanthines (eg, aminophylline). In this narrative review, we summarize the current evidence and present the research gaps related to these therapies in the pediatric population.
DharmageSC, PerretJL, CustovicA. Epidemiology of asthma in children and adults. Front Pediatr, 2019; 7:246; doi: 10.3389/fped.2019.00246
3.
BushA, FlemingL, SaglaniS. Severe asthma in children. Respirology, 2017; 22(5):886–897; doi: 10.1111/resp.13085
4.
AbellardA, PappalardoAA. Overview of severe asthma, with emphasis on pediatric patients: a review for practitioners. J Investig Med, 2021; 69(7):1297–1309; doi: 10.1136/jim-2020-001752
5.
AsherMI, García-MarcosL, PearceNE, et al.Trends in worldwide asthma prevalence. Eur Respir J, 2020; 56(6):2002094; doi: 10.1183/13993003.02094-2020
6.
Al-ShamraniA, Al-HarbiAS, BagaisK, et al.Management of asthma exacerbation in the emergency departments. Int J Pediatr Adolesc Med, 2019; 6(2):61–67; doi: 10.1016/j.ijpam.2019.02.001
7.
CarrollCL, SalaKA. Pediatric status asthmaticus. Crit Care Clin, 2013; 29(2):153–166; doi: 10.1016/j.ccc.2012.12.001
8.
PapiA, BrightlingC, PedersenSE, et al.Asthma. Lancet, 2018; 391(10122):783–800; doi: 10.1016/S0140-6736(17)33311-1
9.
RogersonCM, HoganAH, WaldoB, et al.Wide institutional variability in the treatment of pediatric critical asthma: a multicenter retrospective study. Pediatr Crit Care Med, 2024; 25(1):37–46; doi: 10.1097/PCC.0000000000003347
10.
CONTROLLED trial of effects of cortisone acetate in status asthmaticus; report to the Medical Research Council by the subcommittee on clinical trials in asthma. Lancet, 1956; 271(6947):803–806.
11.
WilliamsDM. Clinical pharmacology of corticosteroids. Respir Care, 2018; 63(6):655–670; doi: 10.4187/respcare.06314
12.
BarnesPJ, AdcockIM. How do corticosteroids work in asthma? Ann Intern Med, 2003; 139(5 Pt 1):359–370; doi: 10.7326/0003-4819-139-5_part_1-200309020-00012
13.
LevyML, BacharierLB, BatemanE, et al.Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update. NPJ Prim Care Respir Med, 2023; 33(1):7; doi: 10.1038/s41533-023-00330-1
14.
KewKM, FlemyngE, QuonBS, et al.Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children. Cochrane Database Syst Rev, 2022; 9(9):CD007524; doi: 10.1002/14651858.CD007524.pub5
15.
SmithM, IqbalS, ElliottTM, et al.Corticosteroids for hospitalised children with acute asthma. Cochrane Database Syst Rev, 2003; 2003(2):CD002886; doi: 10.1002/14651858.CD002886
16.
KrishnanJA, DavisSQ, NaureckasET, et al.An umbrella review: corticosteroid therapy for adults with acute asthma. Am J Med, 2009; 122(11):977–991; doi: 10.1016/j.amjmed.2009.02.013
17.
HussainN, Suleman, JavedA, YousafM. Comparison of outcome between dexamethasone versus prednisolone administration in acute moderate asthma. PJMHS, 2023; 17(4):31–32; doi: 10.5335/0/pjmhs202317431
18.
DoymazS, AhmedYE, FrancoisD, et al.Methylprednisolone, dexamethasone or hydrocortisone for acute severe pediatric asthma: does it matter? J Asthma, 2022; 59(3):590–596; doi: 10.1080/02770903.2020.1870130
19.
RoddyMR, SellersAR, DarvilleKK, et al.Dexamethasone versus methylprednisolone for critical asthma: a single center, open-label, parallelgroup clinical trial. Pediatr Pulmonol, 2023; 58(6):1719–1727; doi: 10.1002/ppul.26386
20.
ParikhK, HallM, MittalV, et al.Comparative effectiveness of dexamethasone versus prednisone in children hospitalized with asthma. J Pediatr, 2015; 167(3):639–644.e1; doi: 10.1016/j.jpeds.2015.06.038
21.
TylerA, CotterJM, MossA, et al.Outcomes for pediatric asthmatic inpatients after implementation of an emergency department dexamethasone treatment protocol. Hosp Pediatr, 2019; 9(2):92–99; doi: 10.1542/hpeds.2018-0099
22.
BohannonK, MachenR, RagsdaleC, et al.Dexamethasone associated with significantly shorter length of hospital stay compared with a prednisolone-based regimen in pediatric patients with mild to moderate acute asthma exacerbations. Clin Pediatr (Phila), 2019; 58(5):521–527; doi: 10.1177/0009922819832091
23.
HemaniSA, GloverB, BallS, et al.Dexamethasone versus prednisone in children hospitalized for acute asthma exacerbations. Hosp Pediatr, 2021; 11(11):1263–1272; doi: 10.1542/hpeds.2020-004788
24.
HoefgenER, HuangB, SchulerCL, et al.Dexamethasone versus prednisone in children hospitalized with asthma exacerbation. Hosp Pediatr, 2022; 12(3):325–335; doi: 10.1542/hpeds.2021-006276
25.
SellersAR, RoddyMR, DarvilleKK, et al.Dexamethasone for pediatric critical asthma: a multicenter descriptive study. J Intensive Care Med, 2022; 37(11):1520–1527; doi: 10.1177/08850666221082540
26.
National Asthma Education and Prevention Program. Expert Panel Report 3 (EPR-3): guidelines for the diagnosis and management of Asthma-Summary Report 2007. J Allergy Clin Immunol, 2007; 120(5 Suppl):S94–S138.
27.
NormansellR, KewKM, MansourG. Different oral corticosteroid regimens for acute asthma. Cochrane Database Syst Rev, 2016; 2016(5):CD011801; doi: 10.1002/14651858.CD011801.pub2
28.
AllenDB, MullenM, MullenB. A meta-analysis of the effect of oral and inhaled corticosteroids on growth. J Allergy Clin Immunol, 1994; 93(6):967–976; doi: 10.1016/s0091-6749(94)70043-5
29.
AljebabF, ChoonaraI, ConroyS. Systematic review of the toxicity of long-course oral corticosteroids in children. PLoS One, 2017; 12(1):e0170259; doi: 10.1371/journal.pone.0170259
30.
BleeckerER, Al-AhmadM, BjermerL, et al.Systemic corticosteroids in asthma: a call to action from World allergy organization and respiratory effectiveness group. World Allergy Organ J, 2022; 15(12):100726; doi: 10.1016/j.waojou.2022.100726
31.
BushA, PedersenS, HedlinG, et al.;PSACI (Problematic Severe Asthma in Childhood Initiative) group. Pharmacological treatment of severe, therapy-resistant asthma in children: what can we learn from where? Eur Respir J, 2011; 38(4):947–958; doi: 10.1183/09031936.00030711
JohnsonM. The beta-adrenoceptor. Am J Respir Crit Care Med, 1998; 158(5 Pt 3):S146–S153; doi: 10.1164/ajrccm.158.supplement_2.13tac110
34.
Marieke Kruidering-HallBGK, TuanRL, VanderahTW. Drugs used in asthma & chronic obstructive pulmonary disease. In: Katzung’s Pharmacology Examination & Board Review. 14th edition. McGraw-Hill Education: New York, NY; 2024; pp. 172–180.
35.
ArnoldDH, MoorePE, AbramoTJ, et al.The dilemma of albuterol dosing for acute asthma exacerbations in pediatric patients. Chest, 2011; 139(2):472; doi: 10.1378/chest.10-2163
36.
CamargoCAJr, SpoonerCH, RoweBH. Continuous versus intermittent beta-agonists in the treatment of acute asthma. Cochrane Database Syst Rev, 2003; 2003(4):CD001115; doi: 10.1002/14651858.CD001115
37.
MolerFW, JohnsonCE, Van LaanenC, et al.Continuous versus intermittent nebulized terbutaline: plasma levels and effects. Am J Respir Crit Care Med, 1995; 151(3 Pt 1):602–606; doi: 10.1164/ajrccm/151.3_Pt_1.602
38.
MartinoR, VegasE, TorrijosC, et al.Continuous albuterol nebulization in the treatment of acute asthma in children. Acta Pediatrica ESPANOLA, 2000; 58(9):508–512.
39.
KulalertP, PhinyoP, PatumanondJ, et al.Continuous versus intermittent short-acting b2-agonists nebulization as first-line therapy in hospitalized children with severe asthma exacerbation: a propensity score matching analysis. Asthma Res Pract, 2020; 6:6.
40.
PapoMC, FrankJ, ThompsonAE. A prospective, randomized study of continuous versus intermittent nebulized albuterol for severe status asthmaticus in children. Crit Care Med, 1993; 21(10):1479–1486; doi: 10.1097/00003246-199310000-00015
41.
MillerAG, RobertsKJ, SmithBJ, et al.;American Association collaborators. Prevalence of burnout among respiratory therapists amidst the COVID-19 pandemic. Respir Care, 2021; 66(11):1639–1648; doi: 10.4187/respcare.09283
42.
MaueDK, ToriAJ, BeardsleyAL, et al.Implementing a respiratory therapist-driven continuous albuterol weaning protocol in the PICU. Respir Care, 2019; 64(11):1358–1365; doi: 10.4187/respcare.06447
43.
MillerAG, HaynesKE, GatesRM, et al.A respiratory therapist-driven asthma pathway reduced hospital length of stay in the pediatric intensive care unit. Respir Care, 2019; 64(11):1325–1332; doi: 10.4187/respcare.06626
44.
WillisLD, DannerNP, LloydTL, et al.Safe and effective use of score-based continuous albuterol therapy in a pathway for treatment of pediatric asthma exacerbation. Respir Care, 2022; 67(11):1396–1404; doi: 10.4187/respcare.10083
45.
PhumeethamS, BahkTJ, Abd-AllahS, et al.Effect of high-dose continuous albuterol nebulization on clinical variables in children with status asthmaticus. Pediatr Crit Care Med, 2015; 16(2):e41–e46; doi: 10.1097/PCC.0000000000000314
46.
Parlar-ChunR, ArnoldK. Association of various weight-based doses of continuous albuterol on hospital length of stay. J Asthma, 2021; 58(5):645–650; doi: 10.1080/02770903.2020.1723622
47.
LinAT, Moore-ClingenpeelM, KarsiesTJ. Comparison of two continuous nebulized albuterol doses in critically ill children with status asthmaticus. J Asthma, 2020; 57(9):980–986; doi: 10.1080/02770903.2019.1623249
48.
RogersonCM, WhiteBR, SmithM, et al.Institutional variability in respiratory support use for pediatric critical asthma: a multicenter retrospective study. Ann Am Thorac Soc, 2024; 21(4):612–619; doi: 10.1513/AnnalsATS.202309-807OC
49.
Al-SubuAM, HagenS, EldridgeM, et al.Aerosol therapy through high flow nasal cannula in pediatric patients. Expert Rev Respir Med, 2017; 11(12):945–953; doi: 10.1080/17476348.2017.1391095
50.
LiJ, WilliamsL, FinkJB. The impact of high-flow nasal cannula device, nebulizer type, and placement on trans-nasal aerosol drug delivery. Respir Care, 2022; 67(1):1–8; doi: 10.4187/respcare.09133
51.
AlanaziO, LiJ. The impact of various high-flow nasal cannula devices on transnasal aerosol delivery. Respir Care, 2023; 68(12):1657–1661; doi: 10.4187/respcare.10777
QureshiF, PestianJ, DavisP, et al.Effect of nebulized ipratropium on the hospitalization rates of children with asthma. N Engl J Med, 1998; 339(15):1030–1035; doi: 10.1056/NEJM199810083391503
54.
Rodriguez-MartinezCE, Sossa-BriceñoMP, BuendiaJA. The use of ipratropium bromide for treating moderate to severe asthma exacerbations in pediatric patients in an emergency setting: a cost-effectiveness analysis. Pediatr Pulmonol, 2021; 56(12):3706–3713.
55.
CravenD, KercsmarCM, MyersTR, et al.Ipratropium bromide plus nebulized albuterol for the treatment of hospitalized children with acute asthma. J Pediatr, 2001; 138(1):51–58; doi: 10.1067/mpd.2001.110120
56.
GogginN, MacarthurC, ParkinPC. Randomized trial of the addition of ipratropium bromide to albuterol and corticosteroid therapy in children hospitalized because of an acute asthma exacerbation. Arch Pediatr Adolesc Med, 2001; 155(12):1329–1334; doi: 10.1001/archpedi.155.12.1329
57.
TeohL, CatesCJ, HurwitzM, et al.Anticholinergic therapy for acute asthma in children. Cochrane Database Syst Rev, 2012; 2012(4):CD003797; doi: 10.1002/14651858.CD003797.pub2
58.
MurphyK, MahmoodN, CravenD, et al.Randomized pilot trial of ipratropium versus placebo in children with critical asthma. Pediatr Pulmonol, 2020; 55(12):3287–3292; doi: 10.1002/ppul.25115
59.
AaronSD. The use of ipratropium bromide for the management of acute asthma exacerbation in adults and children: a systematic review. J Asthma, 2001; 38(7):521–530; doi: 10.1081/jas-100107116
60.
HaasDA, HarperDG. Ketamine: a review of its pharmacologic properties and use in ambulatory anesthesia. Anesth Prog, 1992; 39(3):61–68.
61.
SatoT, HirotaK, MatsukiA, et al.The role of the N-methyl-D-aspartic acid receptor in the relaxant effect of ketamine on tracheal smooth muscle. Anesth Analg, 1998; 87(6):1383–1388; doi: 10.1213/00000539-199812000-00033
62.
SarmaVJ. Use of ketamine in acute severe asthma. Acta Anaesthesiol Scand, 1992; 36(1):106–107; doi: 10.1111/j.1399-6576.1992.tb03432.x
63.
L’HommedieuCS, ArensJJ. The use of ketamine for the emergency intubation of patients with status asthmaticus. Ann Emerg Med, 1987; 16(5):568–571; doi: 10.1016/s0196-0644(87)80688-1
64.
NehamaJ, PassR, Bechtler-KarschA, et al.Continuous ketamine infusion for the treatment of refractory asthma in a mechanically ventilated infant: case report and review of the pediatric literature. Pediatr Emerg Care, 1996; 12(4):294–297.
65.
AllenJY, MaciasCG. The efficacy of ketamine in pediatric emergency department patients who present with acute severe asthma. Ann Emerg Med, 2005; 46(1):43–50; doi: 10.1016/j.annemergmed.2005.02.024
66.
TiwariA, GuglaniV, JatKR. Ketamine versus aminophylline for acute asthma in children: a randomized, controlled trial. Ann Thorac Med, 2016; 11(4):283–288; doi: 10.4103/1817-1737.191874
67.
La ViaL, SanfilippoF, CuttoneG, et al.Use of ketamine in patients with refractory severe asthma exacerbations: systematic review of prospective studies. Eur J Clin Pharmacol, 2022; 78(10):1613–1622; doi: 10.1007/s00228-022-03374-3
68.
RehderKJ. Adjunct therapies for refractory status asthmaticus in children. Respir Care, 2017; 62(6):849–865; doi: 10.4187/respcare.05174
69.
BinsaeeduAS, PrabakarD, AshkarM, et al.Evaluating the safety and efficacy of ketamine as a bronchodilator in pediatric patients with acute asthma exacerbation: a review. Cureus, 2023; 15(6):e40789; doi: 10.7759/cureus.40789
70.
GriffithsB, KewKM. Intravenous magnesium sulfate for treating children with acute asthma in the emergency department. Cochrane Database Syst Rev, 2016; 4(4):CD011050; doi: 10.1002/14651858.CD011050.pub2
71.
DeviPR, KumarL, SinghiSC, et al.Intravenous magnesium sulfate in acute severe asthma not responding to conventional therapy. Indian Pediatr, 1997; 34(5):389–397.
72.
TorresS, SticcoN, BoschJJ, et al.Effectiveness of magnesium sulfate as initial treatment of acute severe asthma in children, conducted in a tertiary-level university hospital: a randomized, controlled trial. Arch Argent Pediatr, 2012; 110(4):291–296.
73.
ArnoldDH, GongW, AntoonJW, et al.Prospective observational study of clinical outcomes after intravenous magnesium for moderate and severe acute asthma exacerbations in children. J Allergy Clin Immunol Pract, 2022; 10(5):1238–1246; doi: 10.1016/j.jaip.2021.11.028
74.
SantanaJC, BarretoSS, PivaJP, et al.Randomized clinical trial of intravenous magnesium sulfate versus salbutamol in early management of severe acute asthma in children. J Pediatr (Rio J), 2001; 77(4):279–287; doi: 10.2223/jped.235
75.
SheinSL, FarhanO, MorrisN, et al.Adjunctive pharmacotherapies in children with asthma exacerbations requiring continuous albuterol therapy: findings from the Ohio Pediatric Asthma Repository. Hosp Pediatr, 2018; 8(2):89–95; doi: 10.1542/hpeds.2017-0088
76.
DeSantiRL, AgasthyaN, HunterK, et al.The effectiveness of magnesium sulfate for status asthmaticus outside the intensive care setting. Pediatr Pulmonol, 2018; 53(7):866–871; doi: 10.1002/ppul.24013
77.
AntoonJW, HallM, MittalV, et al.Intravenous magnesium and hospital outcomes in children hospitalized with asthma. Hosp Pediatr, 2021; 11(8):785–793; doi: 10.1542/hpeds.2020-004770
78.
IrazuztaJ, EgelundT, WassilSK, et al.Feasibility of short-term infusion of magnesium sulfate in pediatric patients with status asthmaticus. J Pediatr Pharmacol Ther, 2012; 17(2):150–154; doi: 10.5863/1551-6776-17.2.150
79.
EgelundTA, WassilSK, EdwardsEM, et al.High-dose magnesium sulfate infusion protocol for status asthmaticus: a safety and pharmacokinetics cohort study. Intensive Care Med, 2013; 39(1):117–122; doi: 10.1007/s00134-012-2734-6
80.
VaiyaniD, IrazuztaJE. Comparison of two high-dose magnesium infusion regimens in the treatment of status asthmaticus. J Pediatr Pharmacol Ther, 2016; 21(3):233–238; doi: 10.5863/1551-6776-21.3.233
81.
IrazuztaJE, ParedesF, PavlicichV, et al.High-dose magnesium sulfate infusion for severe asthma in the emergency department: efficacy study. Pediatr Crit Care Med, 2016; 17(2):e29–e33; doi: 10.1097/PCC.0000000000000581
82.
TaherKW, JohnsonPN, MillerJL, et al.Efficacy and safety of prolonged magnesium sulfate infusions in children with refractory status asthmaticus. Front Pediatr, 2022; 10:860921; doi: 10.3389/fped.2022.860921
83.
GloverML, MachadoC, TotapallyBR. Magnesium sulfate administered via continuous intravenous infusion in pediatric patients with refractory wheezing. J Crit Care, 2002; 17(4):255–258; doi: 10.1053/jcrc.2002.36759
84.
GraffDM, StevensonMD, BerkenboschJW. Safety of prolonged magnesium sulfate infusions during treatment for severe pediatric status asthmaticus. Pediatr Pulmonol, 2019; 54(12):1941–1947; doi: 10.1002/ppul.24499
85.
PerssonCG. On the medical history of xanthines and other remedies for asthma: a tribute to HH Salter. Thorax, 1985; 40(12):881–886; doi: 10.1136/thx.40.12.881
86.
BarnesPJ. Theophylline. Am J Respir Crit Care Med, 2013; 188(8):901–906; doi: 10.1164/rccm.201302-0388PP
87.
CooneyL, SinhaI, HawcuttD. Aminophylline dosage in asthma exacerbations in children: a systematic review. PLoS One, 2016; 11(8):e0159965; doi: 10.1371/journal.pone.0159965
88.
PiersonWE, BiermanCW, StammSJ, et al.Double-blind trial of aminophylline in status asthmaticus. Pediatrics, 1971; 48(4):642–646; doi: 10.1542/peds.48.4.642
89.
HambletonG, StoneMJ. Comparison of IV salbutamol with IV aminophylline in the treatment of severe, acute asthma in childhood. Arch Dis Child, 1979; 54(5):391–392; doi: 10.1136/adc.54.5.391
90.
DiGiulioGA, KercsmarCM, KrugSE, et al.Hospital treatment of asthma: lack of benefit from theophylline given in addition to nebulized albuterol and intravenously administered corticosteroid. J Pediatr, 1993; 122(3):464–469; doi: 10.1016/s0022-3476(05)83442-0
91.
CarterE, CruzM, ChesrownS, et al.Efficacy of intravenously administered theophylline in children hospitalized with severe asthma. J Pediatr, 1993; 122(3):470–476; doi: 10.1016/s0022-3476(05)83443-2
92.
StraussRE, WertheimDL, BonaguraVR, et al.Aminophylline therapy does not improve outcome and increases adverse effects in children hospitalized with acute asthmatic exacerbations. Pediatrics, 1994; 93(2):205–210.
93.
BienJP, BloomMD, EvansRL, et al.Intravenous theophylline in pediatric status asthmaticus. A prospective, randomized, double-blind, placebo-controlled trial. Clin Pediatr (Phila), 1995; 34(9):475–481; doi: 10.1177/000992289503400905
94.
NeedlemanJP, KaiferMC, NoldJT, et al.Theophylline does not shorten hospital stay for children admitted for asthma. Arch Pediatr Adolesc Med, 1995; 149(2):206–209; doi: 10.1001/archpedi.1995.02170140088016
95.
NuhoğluY, DaiA, BarlanIB, et al.Efficacy of aminophylline in the treatment of acute asthma exacerbation in children. Ann Allergy Asthma Immunol, 1998; 80(5):395–398.
96.
YungM, SouthM. Randomised controlled trial of aminophylline for severe acute asthma. Arch Dis Child, 1998; 79(5):405–410; doi: 10.1136/adc.79.5.405
97.
ReamRS, LoftisLL, AlbersGM, et al.Efficacy of IV theophylline in children with severe status asthmaticus. Chest, 2001; 119(5):1480–1488; doi: 10.1378/chest.119.5.1480
98.
RobertsG, NewsomD, GomezK, et al.;North West Thames Asthma Study Group. Intravenous salbutamol bolus compared with an aminophylline infusion in children with severe asthma: a randomised controlled trial. Thorax, 2003; 58(4):306–310; doi: 10.1136/thorax.58.4.306
99.
WheelerDS, JacobsBR, KenreighCA, et al.Theophylline versus terbutaline in treating critically ill children with status asthmaticus: a prospective, randomized, controlled trial. Pediatr Crit Care Med, 2005; 6(2):142–147; doi: 10.1097/01.PCC.0000154943.24151.58
100.
D’AvilaRS, PivaJP, MarosticaPJC, et al.Early administration of two intravenous bolus of aminophylline added to the standard treatment of children with acute asthma. Respir Med, 2008; 102(1):156–161; doi: 10.1016/j.rmed.2007.07.030
101.
DalabihAR, BondiSA, HarrisZL, et al.Aminophylline infusion for status asthmaticus in the pediatric critical care unit setting is independently associated with increased length of stay and time for symptom improvement. Pulm Pharmacol Ther, 2014; 27(1):57–61; doi: 10.1016/j.pupt.2013.03.001
102.
StulceC, GoudaS, SaidSJ, et al.Terbutaline and aminophylline as second-line therapies for status asthmaticus in the pediatric intensive care unit. Pediatr Pulmonol, 2020; 55(7):1624–1630; doi: 10.1002/ppul.24821
103.
ArthurG. Epinephrine: a short history. Lancet Respir Med, 2015; 3(5):350–351; doi: 10.1016/S2213-2600(15)00087-9
104.
MayCS, PatersonJW, SpiroSG, et al.Effect of intravenous injection of salbutamol in asthma. Br J Clin Pharmacol, 1975; 2(6):495–501; doi: 10.1111/j.1365-2125.1975.tb00566.x
105.
SteinSW, ThielCG. The history of therapeutic aerosols: a chronological review. J Aerosol Med Pulm Drug Deliv, 2017; 30(1):20–41; doi: 10.1089/jamp.2016.1297
106.
TobinA. Intravenous salbutamol: too much of a good thing? Crit Care Resusc, 2005; 7(2):119–127; doi: 10.1016/S1441-2772(23)01644-7
107.
BoeschotenS, de HoogM, KneyberM, et al.Current practices in children with severe acute asthma across European PICUs: an ESPNIC survey. Eur J Pediatr, 2020; 179(3):455–461; doi: 10.1007/s00431-019-03502-9
108.
BrowneGJ, PennaAS, PhungX, et al.Randomised trial of intravenous salbutamol in early management of acute severe asthma in children. Lancet, 1997; 349(9048):301–305; doi: 10.1016/S0140-6736(96)06358-1
109.
BogieAL, TowneD, LuckettPM, et al.Comparison of intravenous terbutaline versus normal saline in pediatric patients on continuous high-dose nebulized albuterol for status asthmaticus. Pediatr Emerg Care, 2007; 23(6):355–361; doi: 10.1097/01.pec.0000278397.63246.33
110.
KassisseE, JimenezJ, MayoN, et al.Magnesium sulfate vs aminophylline as a second line of treatment in children with severe acute asthma. Randomized clinical trial. Andes Pediatr, 2021; 92(3):367–374; doi: 10.3264/1/andespediatr.v92i3.2969
111.
WoodcockJ, LaVangeLM. Master protocols to study multiple therapies, multiple diseases, or both. N Engl J Med, 2017; 377(1):62–70; doi: 10.1056/NEJMra1510062
112.
EmeriaudG, Lopez-FernandezYM, IyerNP, et al.;Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) Group on behalf of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. Executive summary of the second international guidelines for the diagnosis and management of pediatric acute respiratory distress syndrome (PALICC-2). Pediatr Crit Care Med, 2023; 24(2):143–168; doi: 10.1097/PCC.0000000000003147
JatKR, ChawlaD. Ketamine for management of acute exacerbations of asthma in children. Cochrane Database Syst Rev, 2012; 11(11):CD009293; doi: 10.1002/14651858.CD009293.pub2
115.
JohnsonPN, DruryAS, GuptaN. Continuous magnesium sulfate infusions for status asthmaticus in children: a systematic review. Front Pediatr, 2022; 10:853574; doi: 10.3389/fped.2022.853574
116.
BoeschotenSA, BuysseCMP, MerkusPJFM, et al.;SKIC Dutch collaborative PICU research network. Children with severe acute asthma admitted to Dutch PICUs: a changing landscape. Pediatr Pulmonol, 2018; 53(7):857–865; doi: 10.1002/ppul.24009
MillerAG, RottaAT. Noninvasive respiratory support for pediatric critical asthma. Respir Care, 2025; 70(6):760–776; doi: 10.4187/respcare.12487
119.
Global Initiative for Asthma. GINA Main Report: Global Strategy for Asthma Management and Prevention. Available from: https://ginasthma.org/2024-report/. [Last accessed: September17, 2024].
120.
Abu-SultanehS, IyerNP, FernándezA, et al.Executive summary: international clinical practice guidelines for pediatric ventilator liberation, a Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network document. Am J Respir Crit Care Med, 2023; 207(1):17–28; doi: 10.1164/rccm.202204-0795SO
121.
BrattonSL, NewthCJL, ZuppaAF, et al.;Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network. Critical care for pediatric asthma: wide care variability and challenges for study. Pediatr Crit Care Med, 2012; 13(4):407–414; doi: 10.1097/PCC.0b013e318238b428
122.
RobertsJS, BrattonSL, BroganTV. Acute severe asthma: differences in therapies and outcomes among pediatric intensive care units. Crit Care Med, 2002; 30(3):581–585; doi: 10.1097/00003246-200203000-00015
123.
SchuhS, SweeneyJ, RumantirM, et al.;Pediatric Emergency Research Canada (PERC) Network. Effect of nebulized magnesium vs placebo added to albuterol on hospitalization among children with refractory acute asthma treated in the emergency department: a randomized clinical trial. JAMA, 2020; 324(20):2038–2047; doi: 10.1001/jama.2020.19839
124.
MaueDK, CaterDT, RogersonCM, et al.Outcomes of a respiratory therapist driven high flow nasal cannula management protocol for pediatric critical asthma patients. Pediatr Pulmonol, 2023; 58(10):2881–2888; doi: 10.1002/ppul.26606
