Management of severe asthma exacerbation: guidelines from the Société Française de Médecine d’Urgence, the Société de Réanimation de Langue Française and the French Group for Pediatric Intensive Care and Emergencies,Annals of Intensive Care

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Management of severe asthma exacerbation: guidelines from the Société Française de Médecine d’Urgence, the Société de Réanimation de Langue Française and the French Group for Pediatric Intensive Care and Emergencies
Annals of Intensive Care ( IF 8.1 ) Pub Date : 2019-10-10 , DOI: 10.1186/s13613-019-0584-x
Philippe Le Conte _{1,

2} , Nicolas Terzi _{3,

4} , Guillaume Mortamet ₅ , Fekri Abroug ₆ , Guillaume Carteaux ₇ , Céline Charasse ₈ , Anthony Chauvin ₉ , Xavier Combes ₁₀ , Stéphane Dauger ₁₁ , Alexandre Demoule ₁₂ , Thibaut Desmettre ₁₃ , Stephan Ehrmann ₁₄ , Bénédicte Gaillard-Le Roux ₁₅ , Valérie Hamel ₁₆ , Boris Jung ₁₇ , Sabrina Kepka ₁₈ , Erwan L'Her ₁₉ , Mikaël Martinez _{20,

21} , Christophe Milési ₂₂ , Élise Morawiec ₂₃ , Mathieu Oberlin ₂₄ , Patrick Plaisance ₂₅ , Robin Pouyau ₂₆ , Chantal Raherison ₂₇ , Patrick Ray ₂₈ , Mathieu Schmidt ₂₉ , Arnaud W Thille ₃₀ , Jennifer Truchot ₉ , Guillaume Valdenaire ₃₁ , Julien Vaux ₃₂ , Damien Viglino _{4,

33} , Guillaume Voiriot ₃₄ , Bénédicte Vrignaud ₃₅ , Sandrine Jean ₃₆ , Eric Mariotte ₃₇ , Pierre-Géraud Claret ₃₈

Affiliation

Service d'Accueil des Urgences, CHU de Nantes, 5 allée de l'île gloriette, 44093, Nantes Cedex 1, France.
PHU3, Faculté de Médecine 1, rue Gaston Veil, 44035, Nantes, France.
Service de Médecine Intensive Réanimation, CHU de Grenoble Alpes, 38000, Grenoble, France.
INSERM, U1042, University of Grenoble-Alpes, HP2, 38000, Grenoble, France.
Service de Réanimation Pédiatrique, CHU de Grenoble Alpes, 38000, Grenoble, France.
Service de réanimation, CHU de Monastir, Monastir, Tunisia.
Service de MIR, Hôpital Henri Mondor, APHP, Créteil, France.
Pediatric Emergency Department, CHU Pellegrin Enfants, Bordeaux, France.
Service des Urgences, Hôpital Lariboisière, APHP, Paris, France.
Service des Urgences, CHU de la Réunion, Saint-Denis, France.
Pediatric Intensive Care Unit, Robert Debré Hospital, APHP, Paris, France.
Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie, Médecine Intensive et Réanimation (Département R3S), AP-HP, INSERM, UMRS1158 neurophysiologie respiratoire expérimentale et clinique, Sorbonne Université, Paris, France.
Service des Urgences, CHU de Besançon, Besançon, France.
Médecine Intensive Réanimation, INSERM CIC 1415, réseau CRICS-TriggerSEP, CHRU de Tours and Centre d'Etude des Pathologies Respiratoires, INSERM U1100, faculté de médecine, Université de Tours, Tours, France.
Pediatric Intensive Care Unit, Women and Children's University Hospital, Nantes, France.
Service des Urgences, CHU de Toulouse, Toulouse, France.
Service de MIR, CHU de Montpelliers, Montpellier, France.
Service des Urgences, CHU de Strasbourg, Strasbourg, France.
Service de MIR, CHRU de Brest, Brest, France.
Pôle Urgences, centre hospitalier du Forez, 42605, Montbrison, France.
Réseau d'urgence Ligérien Ardèche Nord (REULIAN), centre hospitalier Le Corbusier, 42700, Firminy, France.
Département de Pédiatrie Néonatale et Réanimations, CHU de Montpellier, Montpellier, France.
Service de Pneumologie et Réanimation, GH Pitié-Salpêtrière, APHP, Paris, France.
Service des Urgences, centre hospitalier de Cahors, Cahors, France.
Service des Urgences, AP-HP, hôpital la Riboisière, Paris, France.
Pediatric Intensive Care Unit, Women-Mothers and Children's University Hospital, Lyon, France.
service de Pneumologie, CHU de Bordeaux, Pessac, France.
Service des Urgences, CHU de Dijon, faculté de médecine de Dijon, Dijon, France.
INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Sorbonne Universités, 75651, Paris Cedex 13, France.
CHU de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
Service des Urgences, CHU de Bordeaux, Pessac, France.
SAMU 94, CHU Henri Mondor, AP-HP, Créteil, France.
Service des Urgences Adultes, CHU de Grenoble Alpes, 38000, Grenoble, France.
Service de réanimation polyvalente, Hôpital Tenon, APHP, Paris, France.
Pediatric Emergency Department, Women and Children', s University Hospital, Nantes, France.
Service de Réanimation Pédiatrique, APHP Hôpital Trousseau, 75012, Paris, France.
Service de Médecine Intensive Réanimation, APHP Hôpital Saint Louis, 75010, Paris, France.
Service d'Accueil des Urgences, CHU de Nîmes, 30029, Nîmes, France.

Background

The French Emergency Medicine Society, the French Intensive Care Society and the Pediatric Intensive Care and Emergency Medicine French-Speaking Group edited guidelines on severe asthma exacerbation (SAE) in adult and pediatric patients.

Results

The guidelines were related to 5 areas: diagnosis, pharmacological treatment, oxygen therapy and ventilation, patients triage, specific considerations regarding pregnant women. The literature analysis and formulation of the guidelines were conducted according to the Grade of Recommendation Assessment, Development and Evaluation methodology. An extensive literature research was conducted based on publications indexed in PubMed™ and Cochrane™ databases. Of the 21 formalized guidelines, 4 had a high level of evidence (GRADE 1+/−) and 7 a low level of evidence (GRADE 2+/−). The GRADE method was inapplicable to 10 guidelines, which resulted in expert opinions. A strong agreement was reached for all guidelines.

Conclusion

The conjunct work of 36 experts from 3 scientific societies resulted in 21 formalized recommendations to help improving the emergency and intensive care management of adult and pediatric patients with SAE.

中文翻译：

严重哮喘发作的管理：法国紧急医疗协会、法语复兴协会和法国儿科重症监护和紧急情况小组的指南

背景

法国急诊医学协会、法国重症监护协会和儿科重症监护和急诊医学法语小组编辑了成人和儿童患者严重哮喘急性发作（SAE）指南。

结果

该指南涉及5个领域：诊断、药物治疗、氧疗和通气、患者分诊、孕妇的具体考虑。根据推荐等级评估、制定和评价方法学进行文献分析和指南制定。根据 PubMed™ 和 Cochrane™ 数据库索引的出版物进行了广泛的文献研究。在 21 项正式指南中，4 项具有高水平证据（GRADE 1+/-），7 项具有低水平证据（GRADE 2+/-）。GRADE方法不适用于10个指南，从而产生了专家意见。就所有指导方针达成了强有力的一致意见。