Consenso chileno SOCHINEP-SER para el diagnóstico y tratamiento del asma en el escolar

Abstract

Chilean SoCHinEP-SER consensus for asthma diagnosis and treatment in school age children Bronchial asthma is the most prevalent chronic condition among children, however, in Chile, it is underdiagnosed. This may be due to medical professionals failing to recognize the disease. It is essential to be aware of the symptoms and signs that are suggestive of the disease in order to begin an appropriate treatment to achieve disease control. Asthma must be suspected in school age children who present repeated episodes of bronchial obstruction. The diagnosis should be confirmed with lung function tests that demonstrate variable airflow obstruction with a positive bronchodilator response. Treatment is based on two fundamental pillars: education and pharmacological treatment. Educational activities must include: information about the disease and its treatment, regular monitoring of treatment adherence, teaching and reviewing the correct inhalation technique at every checkup, developing a personalized written action plan and scheduling regular follow-up appointments. The gold standard for treatment is maintenance inhaled corticosteroids, in the lowest possible dose that enables disease control. The goal of the treatment is to eliminate daily symptoms and asthma crisis. Therapy should be increased if control is not achieved, but before starting it, adherence to maintenance treatment, inhalation technique, presence of associated comorbidities and environmental exposure should be evaluated. In the mild patient, who is not receiving maintenance therapy, rescue treatment should be done with bronchodilators, always associated with inhaled corticosteroids. This consensus is a guide to improve the diagnosis, treatment and control of asthma in schoolchildren

Sulfato de magnesio endovenoso en la exacerbación asmática: ¿es una terapia útil y segura?

“…El nivel plasmático recomendado de magnesio luego de una infusión continua de MgSO4 está por sobre los 4 mg/dl y se correlaciona bien con el nivel de magnesio ionizado que es la forma fisiológicamente activa a nivel celular 8 . Los efectos adversos más frecuentes aparecen con niveles sobre 9mg/dl (náuseas, vómitos, hipotensión arterial, retención urinaria y debilidad muscular) y los graves sobre 12mg/dl (bradicardia o depresión respiratoria) [1][2][3][4][5][6][7][8] . Estos dependerán de condiciones que pueden interferir con su volumen de distribución corporal, metabolización y/o excreción que deberían ser informadas o medidas antes de la realización de estos estudios como son la obesidad, la insuficiencia hepática, la insuficiencia renal y las alteraciones de la conducción cardíaca.…”