ĭestruction of cilia and epithelial denudation render nerve endings irritable, resulting in hyperreactivity. Lymphocytic and eosinophilic submucosal infiltrates in tracheal and bronchial biopsy specimens are reportedly associated with poorer outcomes in adult patients with asthma. Histamines, leukotrienes, and platelet-activating factors are found in increased concentrations locally and systemically.

An interplay of mast cells, T lymphocytes, and epithelial cells results in a circulatory surge of inflammatory cells and cytokines. Increasing understanding of the pathophysiology of asthma at the histological level over the last two decades has emphasized airway inflammation as the primary player, over and above smooth muscle contraction, and airway hyperresponsiveness. Those who live alone are specifically affected. Status asthmatic is more prevalent in individuals with lower socioeconomic status because of less access to specialist care. Multiple observational studies have reported a higher incidence in women, among African Americans, and in subjects with adult-onset asthma, which developed after 17 years. In a retrospective review of 280 hospitalizations over a period of 30 years in the University of Texas, Health Science Center, San Antonio, 61.2% of patients required intubation and mechanical ventilation. Increasing standardization of low tidal volume ventilation strategies, avoiding prolonged neuromuscular blockade, and assisting control mode ventilation hopefully helped reduce this trend even further over the past decade. have reported a mortality of around 10% in the intensive care unit (ICU) patients admitted with status asthmaticus. Īn estimated 3% to 16% of hospitalized adult asthmatic patients progress to respiratory failure requiring ventilatory support, although the statistics might be lower in children. Five percent of them are classified as severe asthma.

Hence, a multi-pronged and time-sensitive approach combining symptoms and signs, assessing airflow and blood gas, and a rapid escalation of treatment based on initial treatment response is favored to diagnose and manage the condition.Īccording to the Center for Disease Control and Prevention (CDC), about 10% of the world population suffers from asthma, with a 15% increase in disease burden in the United States over the last two decades. No single clinical or diagnostic index has been known to predict clinical outcomes in status asthmaticus. If not recognized and managed appropriately, asthmatics portends the risk of acute ventilatory failure and even death.ĭespite advances in pharmacotherapy and access to early diagnosis and treatment of asthma itself, it remains one of the most common causes of emergency department visits. This is also known as status asthmaticus. All patients with bronchial asthma are at risk of developing an acute episode with a progressive severity that is poorly responsive to standard therapeutic measures, regardless of disease severity or phenotypic variant.

Status asthmaticus is a medical emergency, an extreme form of asthma exacerbation characterized by hypoxemia, hypercarbia, and secondary respiratory failure.

Peep definition medical