Presentation
Presentation A 15-year-old girl with severe persistent asthma presents to the emergency department with acute respiratory distress. Her common triggers are environmental allergens, predominantly dogs and cats. [pedsinreview.aappublications.org]
Discussion Berlinski: Thank you for your presentation. [rc.rcjournal.com]
The last may be defined as a persistent and refractory type that is unyielding to presently available therapeutic measures. [jamanetwork.com]
Methods The definition, diagnosis, and treatment of severe asthma are presented on the basis of a selective literature review and the authors’ clinical experience. [ncbi.nlm.nih.gov]
Demographic data, initial presentation data, MICU course, and outcome were collected. Results were compared to our previous study during the 5‐year period 19951999 at this institution. 5 Data are presented as means standard deviations. [journalofhospitalmedicine.com]
Entire Body System
- Pain
Management Frontiers in Medicine Zika Virus Ebola Virus Epidemics Climate Crisis and Health E-Cigarettes and Vaping-Related Disease View all topics Health Policy Epidemics Pain Management Ebola Virus Multimedia Multimedia Selected Multimedia View all [nejm.org]
Other symptoms of an asthma attack associated with status asthmaticus include: difficulty breathing heavy sweating trouble speaking fatigue and weakness abdominal, back, or neck muscle pain panic or confusion blue-tinted lips or skin loss of consciousness [healthline.com]
More than _once a day Once a day 3 to 6 times _a week Once or twice_ a week Not at all Nighttime complaints During the past 4 weeks. how often did your asthma symptoms (wheezing. coughing. shortness of breath. chest tightness or pain) wake you up at night [ncbi.nlm.nih.gov]
- Falling
The affected person becomes fatigued, arterial oxygen tension falls, and carbon dioxide accumulates… Read More [britannica.com]
The advantage of the WHO classification is its realistic assessment of patients with severe asthma: in most cases severe asthma is not therapy resistant but falls into one of the following three categories ( 8 ): Table 2 Classification of severe asthma [ncbi.nlm.nih.gov]
It is unclear at what F IO 2 the clinical benefit of heliox is negated, but many providers question utility once the helium fraction falls below 0.5. [rc.rcjournal.com]
- Malaise
Adverse effects are typically mild and may include generalized weakness, malaise, and hypotension (although the latter has not been reported in studies where magnesium is given as treatment for asthma). [rc.rcjournal.com]
Respiratoric
- Pneumonia
Possible complications from severe asthma include: partial or full lung collapse pneumonia There’s no way to completely prevent severe asthma attacks if you have asthma. [healthline.com]
Respiratory hypersensitivity Allergic bronchopulmonary aspergillosis Hamman-Rich syndrome Idiopathic pulmonary fibrosis Sarcoidosis Obstructive or restrictive Pneumonia / pneumonitis By pathogen Viral Bacterial Pneumococcal Klebsiella ) Atypical bacterial [dictionnaire.sensagent.leparisien.fr]
Complications included ventilator‐associated pneumonia, catheter‐related infection, excessive sedation, and prolonged weakness. [journalofhospitalmedicine.com]
Other potential causes include: allergic reactions to foods chlamydial pneumonia cold viruses herpes simplex virus infections Sometimes, a doctor may not be able to identify the cause of status asthmaticus. [medicalnewstoday.com]
[…] limited by degree of hypoxemia in pt. 70/30 or 80/20 Ketamine - If sedation is needed, preferred drug due to bronchodilating properties, typical dosing range 0.1-2 mg/kg/hr Zithromax - Most common infectious trigger for asthma is Mycoplasma or Chlamydia pneumoniae [uichildrens.org]
- Rhinitis
Allergic Rhinitis Allergic rhinitis is almost ubiquitous in children with asthma living in urban areas. [frontiersin.org]
References External links Penn State Pathology of respiratory system ( J, 460–519 ), respiratory diseases Upper RT (including URTIs, Common cold ) Head sinuses Sinusitis nose Rhinitis Vasomotor rhinitis Atrophic rhinitis Hay fever Nasal polyp Rhinorrhea [dictionnaire.sensagent.leparisien.fr]
Allergic rhinitis is associated with poor asthma control in children with asthma. Thorax 2012; 67(7):582-7. [ Links ] 13. Anfuso A, Ramadan H, Terrell A, Demirdag Y, Walton C, Skoner D, et al. [scielo.edu.uy]
Allergic rhinitis and its impact on asthma (ARIA): Achievements in 10 years and future needs. J Allergy Clin Immunol. 2012; 130 :1049–1062. [ PubMed ] [ Google Scholar ] 24. Kolbe J, Vamos M, Fergusson W. [ncbi.nlm.nih.gov]
- Respiratory Disorders
Definitions of status asthmaticus 1 n a prolonged and severe asthma attack that does not respond to standard treatment Type of: asthma, asthma attack, bronchial asthma respiratory disorder characterized by wheezing; usually of allergic origin [vocabulary.com]
More: Systematic Reviews Management of Childhood Asthma Source: Patient Learn about the Management of Childhood Asthma; the most common respiratory disorder of children. Management of Childhood Asthma page. [evidence.nhs.uk]
Pulmonary rehabilitation for respiratory disorders other than chronic obstructive pulmonary disease. Clin Chest Med. 2014; 35 :369–389. [ PubMed ] [ Google Scholar ] 27. Proskocil BJ, Fryer AD. [ncbi.nlm.nih.gov]
- Rhinorrhea
References External links Penn State Pathology of respiratory system ( J, 460–519 ), respiratory diseases Upper RT (including URTIs, Common cold ) Head sinuses Sinusitis nose Rhinitis Vasomotor rhinitis Atrophic rhinitis Hay fever Nasal polyp Rhinorrhea [dictionnaire.sensagent.leparisien.fr]
Cardiovascular
- Hypertension
Chronic Obstructive Pulmonary Disease (COPD) Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome) Croup Cystic Fibrosis Emphysema Foreign Bodies of the Airway Gastroesophageal Reflux Disease Heart Failure Idiopathic Pulmonary Arterial Hypertension [en.wikipedia.org]
Parasitic noninfectious Chemical / Mendelson's syndrome Aspiration / Lipid By vector/route Community-acquired Healthcare-associated Hospital-acquired By distribution Broncho- Lobar IIP UIP DIP BOOP-COP NSIP RB Other Atelectasis circulatory Pulmonary hypertension [dictionnaire.sensagent.leparisien.fr]
I want to go back to the use of large dose of steroids; there are probably 10 or 15 y of data that show increased doses just give you more adverse effects, hypertension, increased glucose, and not any additional benefits. [rc.rcjournal.com]
- Heart Disease
Psychogenic hyperventilation Chronic obstructive pulmonary disease (COPD) Heart failure Drug side effects (e.g. [ncbi.nlm.nih.gov]
Psychiatrical
- Anxiety Disorder
Evidence of a psychiatric disorder—depression or an anxiety disorder is present in up to 50% of patients—should be clarified by a specialized physician ( 11, 12 ). [ncbi.nlm.nih.gov]
Neurologic
- Confusion
Symptoms A severe asthma attack can cause symptoms such as: Shortness of breath Can’t speak in full sentences Feel breathless even when you lie down Chest feels tight Bluish tint to your lips Feel agitated, confused, or can’t concentrate Hunched shoulders [webmd.com]
Other symptoms of an asthma attack associated with status asthmaticus include: difficulty breathing heavy sweating trouble speaking fatigue and weakness abdominal, back, or neck muscle pain panic or confusion blue-tinted lips or skin loss of consciousness [healthline.com]
This includes anxiety, confusion, and a blue tinge to the lips and fingernails. Without treatment, status asthmaticus can cause death. A person can experience a bronchospasm, where the airways become small. [medicalnewstoday.com]
Treatment
[…] or by oral corticosteroid treatment (for at least six months per year), or is lost when the treatment is reduced. [ncbi.nlm.nih.gov]
Treatment With any asthma attack, you must start treatment right away, at the first sign of symptoms, either at home or in your doctor's office. [webmd.com]
# ↓ MONITORING : Repeat measurement of PEF 15–30 minutes after starting treatment. [handbook.ggcmedicines.org.uk]
Once you have an eosinophilic asthma diagnosis, together, you and your doctor will decide if adding a different kind of asthma treatment could help. [nucala.com]
Five Treatments In a pediatric patient with a severe asthma exacerbation, treatment should be initiated immediately on EMS arrival. This treatment consists of five potentially life-saving interventions. [jems.com]
Prognosis
Chapter 14 Status Asthmaticus and Pending Pulmonary Failure First published: 06 March 2015 Summary This chapter discusses background, prevention, diagnosis, treatment, and prognosis for status asthmaticus and pending pulmonary failure. [onlinelibrary.wiley.com]
Prognosis Unless you have a complicating illness like congestive heart failure or chronic obstructive pulmonary disease, you should do well as long as you get treatment on time. Pagination [webmd.com]
Etiology
Notwithstanding, allergen immunotherapy (AIT) is considered the only etiological treatment able to prevent asthma development ( 97 ), to improve asthma symptoms in AR affected children ( 98 ), and to prevent new sensitizations in already sensitized patients [frontiersin.org]
Epidemiology
According to a new randomized control trial ketamine and aminophylline are also effective in children with acute asthma who responds poorly to standard therapy. [4] Epidemiology [ edit ] Status asthmaticus is slightly more common in males and is more [en.wikipedia.org]
Epidemiology Status asthmaticus is slightly more common in males and is more common among African Americans and Hispanics. [dictionnaire.sensagent.leparisien.fr]
The epidemiology of severe childhood asthma. En: Forno E, Sagliani S, eds. Severe asthma in children and adolescents. mechanisms and management. Cham, CH: Springer, 2020:3-18. [ Links ] 9. [scielo.edu.uy]
Asthma in France: a review of descriptive epidemiological data. Rev Mal Respir. 2010;27:151–9. 2. Asher I, Pearce N. Global burden of asthma among children. Int J Tuberc Lung Dis. 2014;18:1269–78. 3. Werner HA. [annalsofintensivecare.springeropen.com]
Relationships of active and passive smoking to total IgE in adults of the Epidemiological Study of the Genetics and Environment of Asthma, Bronchial Hyperresponsiveness, and Atopy (EGEA). [frontiersin.org]
Pathophysiology
Pathophysiological phenotyping in those with true severe therapy-resistant asthma (STRA) and the current array of add-on therapies will be discussed. [journals.lww.com]
Irregularities in the heart beat and abnormal lowering of the blood pressure may be observed. [2] Pathophysiology [ edit ] Inflammation in asthma is characterized by an influx of eosinophils during the early-phase reaction and a mixed cellular infiltrate [en.wikipedia.org]
The gene locus glutathione dependent S-nitrosoglutathione (GSNOR) has been suggested as one possible correlation to development of status asthmaticus. [ 1 ] Pathophysiology Inflammation in asthma is characterized by an influx of eosinophils during the [dictionnaire.sensagent.leparisien.fr]
Chest 1976 ;70: 740 - 746 Google Scholar | Crossref | Medline | ISI Hopewell PC, Miller RT Pathophysiology and management of severe asthma. [journals.sagepub.com]
Schematic demonstrating asthma pathophysiology. Note the change in the cross-sectional airway from a normal airway (A) to an asthma bronchiole (B), with smooth muscle bronchoconstriction, mucosal edema, and mucus clinging to airway walls. [rc.rcjournal.com]
Prevention
Chapter 14 Status Asthmaticus and Pending Pulmonary Failure First published: 06 March 2015 Summary This chapter discusses background, prevention, diagnosis, treatment, and prognosis for status asthmaticus and pending pulmonary failure. [onlinelibrary.wiley.com]
Based on these premises, it is reasonable that prevention strategies and proper treatments of atopic diseases could prevent occurrence of severe asthma and viceversa. [frontiersin.org]
Prevention You may not be able to prevent all severe asthma attacks. But you can take steps to make them less likely: Take your asthma medication as often as your doctor recommends. Use a peak flow meter several times a day. [webmd.com]