To: Contemporary treatment of children with critical and near-fatal asthma - Critical Care Science (CCS)

To: Contemporary treatment of children with critical and near-fatal asthma |

To the Editor

The review article by Shein et al.⁽⁾ on the treatment of acute severe asthma in children is timely due to the prevalence of the disease and often variable and inconsistent disease management, which includes adjuvant therapies and depends on the availability of resources, the local practices and the preference of doctors. The risk of death in patients subjected to mechanical ventilation for severe acute asthma was analyzed by Pendergraph et al.,⁽⁾ who concluded that the in-hospital mortality rate was 60 to 90 times higher (approximately 10%) for patients who require intubation, with or without admission to an intensive care unit, than for patients who were not intubated. Herein, we discuss two topics related to the review article that can prevent intubation and its complications in severe asthma: the early use of high flow nasal cannula (HFNC) and intravenous magnesium sulfate in the emergency department.

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