The management of children with acute
asthma remains a difficult and challenging process. Although newer
asthma medications are being developed, they are unlikely to have a large impact on the management of children with acute
asthma. The
leukotriene inhibitors are new
anti-inflammatory agents for
asthma and are beneficial for the treatment of patients with chronic
asthma but have no
therapeutic effect during the acute phase of an exacerbation. Older treatments, including the use of
magnesium and
heliox, have been revisited. Although some children with severe
asthma may respond, these do not provide relief for most children with acute exacerbation. The new challenge for
asthma care is finding ways to link children with their primary care providers so that regular
asthma care can be established. The NHLBI recommends that children with
asthma have regular visits with their primary care providers (e.g., four times a year). Regular care results in better adherence to medical and preventive management plans and improves the relationship between patients and physicians. Instituting an
asthma action plan, which instructs families on when and how to begin
therapy for an acute exacerbation, may prevent progression to a more severe condition.