William C. Miller, G. Ralph Corey, Gunther J. Lallinger, David T. Durack

Asthma is a common disease that afflicts as many as 5% of Americans. Severe exacerbations of asthma can be life-threatening if not treated aggressively. Despite publication of therapeutic guidelines developed by experts in this field, the clinical management of severe exacerbations of asthma varies widely among institutions and practitioners. This article briefly reviews the pathophysiology of asthma and outlines a systematic, mechanistic approach to treating patients with severe asthma that integrates many clinical advancements made during the past 5 to 10 years.