Asthma exacerbations in children is one of the most common medical conditions requiring urgent visits to primary healthcare providers or emergency departments, and even hospitalisations. Currently, there is significant variation in the management of asthma exacerbations expressed in guideline recommendations versus clinical practice. This disconnect affects diagnostic and treatment decisions for the clinician and patient.

We systematically reviewed the available guidelines providing recommendations for diagnostic and therapeutic management of asthma exacerbations in the paediatric population.

A systematic review of the literature for guidelines published between January 2009 and October 2019 was conducted, using a protocol registered with the international prospective register of systematic reviews (PROSPERO CRD42020221562).

16 asthma exacerbation clinical practice guidelines for children were included. Despite general agreement between guidelines on the definition of asthma exacerbation, there was great variability in the definition of disease severity and assessment of asthma control. This systematic review also highlighted a paucity of recommendations for criteria for hospitalisation and discharge. Many guidelines scored poorly when measured for stakeholder involvement and editorial independence.

Comprehensive and updated guidelines compliant with international standards for clinical guidelines may significantly improve clinical practice quality, promote evidence-based recommendations and provide uniformity of treatment between countries.

儿童哮喘发作是最常见的疾病之一，需要紧急就诊初级保健提供者或急诊室，甚至需要住院治疗。目前，指南建议与临床实践中表达的哮喘急性发作管理存在显着差异。这种脱节会影响临床医生和患者的诊断和治疗决策。

我们系统地回顾了现有指南，这些指南为儿科人群哮喘急性发作的诊断和治疗管理提供了建议。

使用在国际前瞻性系统评价登记册 (PROSPERO CRD42020221562) 注册的方案，对 2009 年 1 月至 2019 年 10 月期间发布的指南文献进行了系统评价。

纳入了 16 项针对儿童的哮喘急性发作临床实践指南。尽管关于哮喘急性发作定义的指南之间普遍一致，但在疾病严重程度的定义和哮喘控制评估方面存在很大差异。该系统评价还强调了缺乏关于住院和出院标准的建议。许多指南在衡量利益相关者参与和编辑独立性时得分很低。

符合临床指南国际标准的全面和更新的指南可以显着提高临床实践质量，促进基于证据的建议并提供国家间治疗的统一性。