چاپ صفحه |  صفحه نخست سامانه |  نویسندگان |  اطلاعات تفضیلی |  دانلود مقاله | دانشگاه علوم پزشکی تبریز |
| نویسنده | نفر چندم مقاله |
|---|---|
| شبنم اسکندرزاده | اول |
| عنوان | متن |
|---|---|
| کلمات کلیدی | MANAGEMENT ، ASTHM، Pediatric |
| خلاصه مقاله | Early symptoms of an exacerbation may include any of the following: Onset of symptoms of respiratory tract infection, An acute or sub-acute increase in wheeze and shortness of breath, An increase in coughing, especially while the child is asleep, Lethargy or reduced exercise tolerance, Impairment of daily activities, including feeding, A poor response to reliever medication. Oxygen saturation from pulse oximetry of <92% on presentation (before oxygen or bronchodilator treatment) is associated with high morbidity and likely need for hospitalization; saturation of 92–95% is also associated with higher risk. Agitation, drowsiness and confusion are features of cerebral hypoxemia. Treat hypoxemia urgently with oxygen by face mask to achieve and maintain percutaneous oxygen saturation 94–98%. The initial dose of inhaled SABA may be given by a pMDI with spacer and mask or mouthpiece or an air-driven nebulizer; or, if oxygen saturation is low, by an oxygen-driven nebulizer. For most children, pMDI plus spacer is favored as it is more efficient than a nebulizer for bronchodilator delivery, and nebulizers can spread infectious particles. The initial dose of SABA is two puffs of salbutamol (100 mcg per puff) or equivalent, except in acute, severe asthma when six puffs should be given. When a nebulizer is used, a dose of 2.5 mg salbutamol solution is recommended, and infection control procedures should be followed. The frequency of dosing depends on the response observed over 1–2 hours. The role of magnesium sulfate is not established for children 5 years and younger, because there are few studies in this age group.Nebulized isotonic magnesium sulfate may be considered as an adjuvant to standard treatment with nebulized salbutamol and ipratropium in the first hour of treatment for children ≥2 years old with acute severe asthma (e.g. oxygen saturation <92, particularly those with symptoms lasting <6 hours. Intravenous magnesium sulfate in a single dose of 40–50 mg/kg (maximum 2 g) by slow infusion (20–60 minutes) has also been used. |
| نام فایل | تاریخ درج فایل | اندازه فایل | دانلود |
|---|---|---|---|
| Tehran.Chalesh.ordibehesht.pdf | 1402/11/27 | 117915 | دانلود |
| MANAGEMENT OF WORSENING.pdf | 1402/11/28 | 163300 | دانلود |
| asthma exacerbation guid.pdf | 1402/11/28 | 738662 | دانلود |
