[Acute dyspnea in childhood. Croup or foreign body--bronchiolitis or asthma?].

The diagnosis and treatment of acute respiratory distress or dyspnea in children needs to consider the age-related major causes, but also the rare causes. In neonates, congenital abnormalities, immaturity of the lungs, perinatal complications and infections are major causes, in infants bronchiolitis/obstructive bronchitis and croup, while in older children and adolescents acute asthmatic attacks and pneumonia predominate. Of critical importance is a clear diagnostic classification, assessment of severity, securement of adequate oxygenation and a carefully taken decision for hospital or ambulatory treatment. Where indicated, less invasive therapeutic options (inhaled bronchodilators, rectal or oral steroids) are to be preferred over more invasive (i.m., i.v.) alternative measures.