Characterization of the variability of care for acute severe asthma: An opportunity for quality improvement initiatives

2021 ◽  
Author(s):  
Carlos E. Rodriguez‐Martinez ◽  
Monica P. Sossa‐Briceño
Keyword(s):  
Quality Improvement ◽  
Severe Asthma ◽  
Acute Severe Asthma

Potentially (near) fatal asthma

2019 ◽  
Vol 40 (6) ◽  
pp. 403-405 ◽  
Author(s):  
Paul A. Greenberger
Keyword(s):  
Severe Asthma ◽  
Health Care Professionals ◽  
Rescue Therapy ◽  
Respiratory Acidosis ◽  
Acute Severe Asthma ◽  
Increased Risk ◽  
High Risk Type ◽  
Fatal Asthma ◽  
Long Acting ◽  
Near Fatal Asthma

Potentially (near) fatal asthma (PFA) defines a subset of patients with asthma who are at increased risk for death from their disease. The diagnosis of PFA should motivate treating physicians, health professionals, and patients to be more aggressive in the monitoring, treatment, and control of this high-risk type of asthma. A diagnosis of PFA is made when any one of the following are present: (1) a history of endotracheal intubation from asthma, (2) acute respiratory acidosis (pH < 7.35) or respiratory failure from acute severe asthma, (3) two or more episodes of acute pneumothorax or pneumomediastinum from asthma, (4) two or more episodes of acute severe asthma, despite the use of long-term oral corticosteroids and other antiasthma medications. There are two predominant phenotypes of near-fatal exacerbations: “subacute” exacerbation and “hyperacute” exacerbation. The best way to “treat” acute severe asthma is 3‐7 days before it occurs (i.e., at the onset of symptoms or change in respiratory function) and to optimize control of asthma by decreasing the number of symptomatic days and the days and/or nights that require rescue therapy and increasing baseline respiratory status in “poor perceivers.” PFA is treated with a multifaceted approach; physicians and health-care professionals should appreciate limitations of pharmacotherapy, including combination inhaled corticosteroid‐long-acting β-agonist products as well as addressing nonadherence, psychiatric, and socioeconomic issues that complicate care.

scholarly journals Terbutaline aerosol given through pear spacer in acute severe asthma.

BMJ ◽  
1982 ◽  
Vol 285 (6345) ◽  
pp. 849-850 ◽  
Author(s):  
M D Morgan ◽  
B V Singh ◽  
M H Frame ◽  
S J Williams
Keyword(s):  
Severe Asthma ◽  
Acute Severe Asthma

Acute severe asthma after immunotherapy with Friedmann's vaccine

2000 ◽  
Vol 26 (4) ◽  
pp. 481-481
Author(s):  
N. Boisseau ◽  
M. Bouregba ◽  
M. Vivinus ◽  
D. Grimaud
Keyword(s):  
Severe Asthma ◽  
Acute Severe Asthma

Acute severe asthma in pregnancy

2003 ◽  
Vol 11 (7) ◽  
pp. 24-29
Author(s):  
Phil Hill
Keyword(s):  
Severe Asthma ◽  
Acute Severe Asthma ◽  
In Pregnancy

scholarly journals The study of severe asthma in Latin America and Spain (1994-2004): characteristics of patients hospitalized with acute severe asthma

2009 ◽  
Vol 35 (7) ◽  
pp. 635-644 ◽  
Author(s):  
Gustavo Javier Rodrigo ◽  
Vicente Plaza ◽  
Jesús Bellido-Casado ◽  
Hugo Neffen ◽  
María Teresa Bazús ◽  
...  
Keyword(s):  
Latin America ◽  
Severe Asthma ◽  
Latin American ◽  
Inhaled Corticosteroids ◽  
Pulmonary Function Tests ◽  
Tertiary Care ◽  
Asthma Management ◽  
Case Series ◽  
Acute Severe Asthma ◽  
The Mean

OBJECTIVE: Studies assessing the characteristics and management of patients hospitalized with asthma have been limited to a small number of facilities and have evaluated short time periods. The present study evaluated long-term changes among hospitalized asthma patients at a large number of facilities. METHODS: This was a retrospective, hospital-based observational case series, designated the Study of Severe Asthma in Latin America and Spain, which was conducted in Spain and in eight Latin-American countries. We reviewed the hospital records of 3,038 patients (age range, 15-69 years) hospitalized with acute severe asthma at one of nineteen tertiary-care hospitals in 1994, 1999 and 2004. RESULTS: Over time, the use of inhaled corticosteroids and long-acting β2 agonists increased significantly, whereas the use of theophylline as a controller medication decreased. The utilization of pulmonary function tests also increased. There was a significant reduction in the mean hospital stay (8.5 days, 7.4 days and 7.1 days in 1994, 1999 and 2004, respectively, p = 0.0001) and a significant increase in the mean of the lowest arterial pH at hospital admission. In contrast, there was a significant decrease in the proportion of cases in which PEF was determined in the emergency room (48.6% in 1994 vs. 43.5% in 2004, p = 0.0001). We found the quality of asthma management and care to be generally better in Spain than in Latin America. CONCLUSIONS: Although there have been certain improvements in the management of asthma between severe exacerbations and during hospitalization, asthma management remains suboptimal in Spain and, especially, in Latin America.

scholarly journals Management of mechanical ventilation in acute severe asthma: practical aspects

2006 ◽  
Vol 32 (4) ◽  
pp. 501-510 ◽  
Author(s):  
Mauro Oddo ◽  
François Feihl ◽  
Marie-Denise Schaller ◽  
Claude Perret
Keyword(s):  
Mechanical Ventilation ◽  
Severe Asthma ◽  
Acute Severe Asthma

FEV1 Response to Levalbuterol vs Racemic Albuterol in Acute Severe Asthma

CHEST Journal ◽  
2004 ◽  
Vol 126 (4) ◽  
pp. 722S ◽  
Author(s):  
Nicola Hanania ◽  
Charles Emerman ◽  
Richard Nowak ◽  
Raymond Claus ◽  
James Roach ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Acute Severe Asthma

scholarly journals Treatment of acute severe asthma assisted by hypothermia

Anaesthesia ◽  
1992 ◽  
Vol 47 (3) ◽  
pp. 223-225 ◽  
Author(s):  
D. BROWNING ◽  
D. T. GOODRUM
Keyword(s):  
Severe Asthma ◽  
Acute Severe Asthma
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