inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 110.35401/2541-9897-2025-10-1-128-135inovmed-1075Research ArticleОБЗОРЫREVIEWSИнтенсивная терапия астматического статуса в педиатрической практикеIntensive Care Management of Pediatric Status Asthmaticushttps://orcid.org/0000-0003-4705-3823БыковЮ. В.BykovYuri V.

Быков Юрий Витальевич, к. м. н., доцент кафедры анестезиологии и реаниматологии с курсом ДПО; врачанестезиолог-реаниматолог

355017, Ставрополь, ул. Мира, д. 310

Yuri V. Bykov, Cand. Sci. (Med.), Associate Professor at the Department of Anesthesiology and Intensive Care with the Additional Professional Education Course; Anesthesiologist-Intensivist

ulitsa Mira 310, Stavropol, 355017

https://orcid.org/0000-0002-9990-7272ОбединА. Н.ObedinAlexander N.

Обедин Александр Николаевич, д. м. н., доцент, заведующий кафедрой анестезиологии и реаниматологии с курсом ДПО; заместитель главного врача по педиатрической помощи

355017, Ставрополь, ул. Мира, д. 310

Alexander N. Obedin, Dr. Sci. (Med.), Associate Professor, Head of the Department of Anesthesiology and Intensive Care with the Additional Professional Education Course; Deputy Chief Physician for Pediatric Care

ulitsa Mira 310, Stavropol, 355017

https://orcid.org/0000-0002-4460-870XМуравьеваА. А.MuravyovaAlla A.

Муравьева Алла Анатольевна, к. м. н., доцент кафедры анестезиологии и реаниматологии с курсом ДПО

355017, Ставрополь, ул. Мира, д. 310

Alla A. Muravyova, Cand. Sci. (Med.), Associate Professor at the Department of Anesthesiology and Intensive Care with the Additional Professional Education Course

ulitsa Mira 310, Stavropol, 355017

https://orcid.org/0000-0003-4729-5101ЗинченкоО. В.ZinchenkoOleg V.

Зинченко Олег Васильевич, к. м. н., доцент кафедры анестезиологии и реаниматологии с курсом ДПО

355017, Ставрополь, ул. Мира, д. 310

Oleg V. Zinchenko, Cand. Sci. (Med.), Associate Professor at the Department of Anesthesiology and Intensive Care with the Additional Professional Education Course

ulitsa Mira 310, Stavropol, 355017

Ставропольский государственный медицинский университет; Детская городская клиническая больница им. Г.К. ФилиппскогоРоссияStavropol State Medical University; Filippskiy Children’s City Clinical HospitalRussian FederationСтавропольский государственный медицинский университет; Ставропольский краевой клинический перинатальный центр № 1РоссияStavropol State Medical University; Stavropol Regional Clinical Perinatal Center No. 1Russian FederationСтавропольский государственный медицинский университетРоссияStavropol State Medical UniversityRussian Federation202530032025101128135Copyright © Быков Ю.В., Обедин А.Н., Муравьева А.А., Зинченко О.В., 20252025Быков Ю.В., Обедин А.Н., Муравьева А.А., Зинченко О.В.Bykov Y.V., Obedin A.N., Muravyova A.A., Zinchenko O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/1075Актуальность

Актуальность: Астматический статус у детей и подростков – экстренное состояние, требующее оказания неотложной специализированной помощи в условиях отделения реанимации и интенсивной терапии.

Цель исследования

Цель исследования: Определение современного состояния проблемы этиопатогенеза, диагностики и интенсивной терапии при астматическом статусе в детском возрасте.

Материалы и методы

Материалы и методы: Выполнен поиск и анализ научных работ с использованием баз данных Cochrane Library, PubMed и Medscape по поисковым словам: «астматический статус, дети и подростки, глюкокортикоиды, интенсивная терапия, искусственная вентиляция легких». Для обзора отобрано 42 источника. Критериями включения работ в обзор были: наличие описания патогенеза, клинических проявлений и особенностей интенсивной терапии при астматическом статусе в детском и подростковом возрасте. Критерием исключения работ из обзора являлись статьи, содержащие информацию по этиопатогенезу, клинике и неотложной помощи при астматическом статусе у пациентов взрослого и пожилого возраста.

Результаты

Результаты: К препаратам первой линии при купировании астматического статуса относят глюкокортикостероиды и β2-агонисты. Важное значение для детей имеет проведение оксигенотерапии, в том числе высокопоточная подача кислорода и неинвазивная вентиляция легких с положительным давлением. К препаратам второй линии относят метликсантины, антихолинергические средства и сульфат магния. При неэффективности медикаментозной терапии у детей с астматическим статусом проводится интубация трахеи и искусственная вентиляция легких.

Заключение

Заключение: Астматический статус в педиатрической практике является неотложным состоянием с высоким летальным риском, требующим грамотного оказания экстренной помощи. Знание пошаговой интенсивной терапии улучшит оказание помощи при данном патологическом состоянии у детей и подростков.

Background

Background: Status asthmaticus (SA) in children and adolescents is a medical emergency that requires immediate specialized care in an intensive care unit.

Objective

Objective: To determine the current state of the problem regarding etiopathogenesis, diagnosis, and intensive care management of pediatric SA.

Materials and methods

Materials and methods: We searched keywords (status asthmaticus, children and adolescents, glucocorticoids, intensive care, mechanical ventilation) in the Cochrane Library, PubMed, and Medscape and analyzed the found papers. We selected 42 sources for the review. The inclusion criterion was the description of the pathogenesis, clinical manifestations, and intensive care features in children and adolescents with SA. The exclusion criterion was the information on etiopathogenesis, clinical manifestations, and emergency care in adults and older adults with SA.

Results

Results: Glucocorticoids and β2-agonists are the first line of therapy in SA. Oxygen therapy, including high-flow oxygen delivery and noninvasive positive pressure ventilation, is critical in pediatric cases. The second-line treatment includes methylxanthines, anticholinergic drugs, and magnesium sulfate. In case of drug treatment failure, children are intubated and placed on mechanical ventilation.

Conclusions

Conclusions: Pediatric SA is a medical emergency with a high mortality risk, requiring competent emergency care. Knowledge of step-by-step intensive therapy will improve the management of this condition in children and adolescents.

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The authors declare that there are no conflicts of interest present.