scholarly journals ACUTE SEVERE ASTHMA

2007 ◽  
Vol 14 (04) ◽  
pp. 586-590 ◽  
Author(s):  
TEHSEEN ASHRAF KOHISTANI
Keyword(s):  
Severe Asthma ◽  
Flow Rate ◽  
Ipratropium Bromide ◽  
Acute Severe Asthma ◽  
Treatment Groups ◽  
Asthmatic Patients ◽  
End Point ◽  
Group 4 ◽  
Adult Asthmatic ◽  
Over Time

Objective: To compare the improvement in peak expiratory flow rate (PEFR) of patients presentingto the emergency department with acute severe asthma by using the following two regimens of broncho-dilator therapy.a) Salbutamol nebulization. b) Salbutamol plus Ipratropium bromide nebulization. c) To compare the hospital admissionrates in the above mentioned two treatment groups. Design: A comparative study. Place and Duration of Study:Military Hospital Rawalpindi, Feb 2002 to Dec 2002. Material and Methods: Sixty adult asthmatic patients with peakexpiratory flow rate (PEFR) less than 200 liters per minute were randomly assigned to nebulization treatment withsalbutamol (5.0 mg initial dose followed by 2 more doses at 30 and 60 minutes) or the same salbutamol regimen plusipratropium bromide (0.5 mg). The primary end point was change in PEFR. The PEFR was measured at 30 minutes,60 minutes and 90 minutes after the onset of study protocol. The proportion of admission in the two groups wasexamined as secondary end point. Results: The increase in PEFR over time was significantly greater in combinedipratropium plus salbutamol group (p = 0.01) also the proportion of admitted patients was less in combined salbutamolplus ipratropium bromide group 4/30 vs 11/30, p = 0.036. Conclusion: The data suggested that combined iratropiumbromide plus salbutamol nebulization was superior to salbutamol nebulization alone and it should be used in the initialmanagement of patients who present with acute severe asthma.

scholarly journals Assessment of Serum Magnesium Level in Patients with Bronchial Asthma

2019 ◽  
Vol 5 (1) ◽  
pp. 38-41
Author(s):  
Md Haroon Ur Rashid ◽  
Md Rezaul Karim Chowdhury ◽  
Md Anwarul Hoque Faraji ◽  
Shamimur Rahman
Keyword(s):  
Severe Asthma ◽  
Bronchial Asthma ◽  
Muscle Power ◽  
Serum Magnesium ◽  
Stable State ◽  
Respiratory Muscles ◽  
Acute Severe Asthma ◽  
Cross Sectional ◽  
Medical College ◽  
Asthmatic Patients

Background: Asthma is one of the most common chronic diseases worldwide and has been increasing in prevalence over the last few decades. Magnesium (Mg++) has been shown to relax bronchial smooth muscle and influence the function of respiratory muscles. Hypomagnesemia has been associated with diminished respiratory muscle power. Objective: The purpose of the present study was to assess the serum Mg++ level in bronchial asthma patients during stable state and during exacerbation (Acute severe asthma). Methodology: This comparative cross-sectional study was conducted in the OPD and IPD of Department of Pulmonology at Enam Medical College and Hospital, Savar, Dhaka, Bangladesh and this study was carried out from January 2017 to December 2017 for a period of one year. Subjects were enrolled from Enam Medical College and Hospital. Patients diagnosed as bronchial asthma were taken as group A and healthy individuals were as a group B. The asthmatic patients were divided into groups those having chronic stable bronchial asthma and those having acute severe asthma. Results: Serum Mg++ level was significantly (p=0.000) lower in asthmatic patients 1.59±0.24 as compared with healthy controls (2.05±0.34) and significantly lower (p=0.006) in asthmatic patients during exacerbation (1.49±0.27) when compared to stable asthmatics (1.69±0.15). Asthmatic on ≥3 drugs has significantly (p=0.000) lower serum Mg++ 1.43±0.23 than those on <3 drugs (1.65±0.22). Conclusions: Serum Mg++ level was significantly lower in asthmatic patients during exacerbations compared with stable asthmatics. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 38-41

Acute Severe Asthma: Changes in Patient Characteristics, Management, and Outcomes over a Period of 20 Years (1997 to 2017), Insights from Cub-Réa Network.

2021 ◽  
Author(s):  
Romy Younan ◽  
Jean Loup Augy ◽  
Bertrand Hermann ◽  
Bertrand Guidet ◽  
Philippe Aegerter ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Multivariate Analysis ◽  
Survival Rate ◽  
Severe Asthma ◽  
Emergency Department Visits ◽  
Adult Patients ◽  
Acute Severe Asthma ◽  
Icu Mortality ◽  
Non Invasive ◽  
Over Time

Abstract Background: While acute severe asthma (ASA) is the leading cause of emergency department visits and the third cause of hospitalization in children younger than 18 years old, there is a lack of data regarding adult patients admitted in intensive care units (ICU) for ASA. We aimed to describe the evolutions in epidemiology, management, and outcomes of ASA in adult patients, over a period of twenty years in the Greater Paris area ICUs (CUB-Réa Database). Methods: Demographics, severity and supportive treatments were collected from the CUB-Réa Database. The primary endpoint was the prevalence of ASA by periods of 5 years. The secondary endpoints were in-ICU survival, in-hospital survival, use of mechanical ventilation including non-invasive and invasive and catecholamine. Multivariate analysis was performed to assess correlating factors of ICU Mortality. Results: Of the 475 357 ICU admissions from January 1997 to January 2016, 7049 were admitted for ASA with a decreasing prevalence over time, respectively 2.8%, 1.7%, 1.1%, and 1.1% of total ICU admissions (p <0.001). The median age was 46 years old [IQR: 25%-75%: 32-59], 3906 (55%) were female, the median SAPS II was 20 [IQR: 13-28], and 1501 (21%) had mechanical ventilation. Over time, age, the SAPSII and the Charlson Comorbidity Index tended to increase. The use of invasive and non-invasive mechanical ventilation increased (p < 0.001), whereas the use of catecholamine decreased (p <0.001). The in-ICU survival rate improved from 97% to 99% (p=0.008). In the multivariate analysis, factors associated with in-ICU mortality were SAPSII (p < 0.001), renal replacement therapy (p < 0.001), catecholamine (p < 0.001), cardiac arrest (p < 0.001), pneumothorax (p < 0.001), ARDS (p < 0.001), sepsis (p < 0.001) and IMV (p < 0.001). Conclusion: ICU admission for ASA remains uncommon and decreases over time. Despite an increasing severity of patients and the use of mechanical ventilation, the use of catecholamine decreases with high in-ICU survival rate which could be related to a better management of mechanical ventilation.

Dose of nebulized ipratropium bromide in acute severe asthma

1991 ◽  
Vol 85 (6) ◽  
pp. 517-520 ◽  
Author(s):  
K.F. Whyte ◽  
G.A. Gould ◽  
A.A. Jeffrey ◽  
M.A.A. Airlie ◽  
D.C. Flenley ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Ipratropium Bromide ◽  
Acute Severe Asthma

Response to nebulizaed ipratropium bromide and terbutaline in acute severe asthma

1992 ◽  
Vol 86 (3) ◽  
pp. 215-218 ◽  
Author(s):  
C. Teale ◽  
J.F.J. Morrison ◽  
M.F. Muers ◽  
S.B. Pearson
Keyword(s):  
Severe Asthma ◽  
Ipratropium Bromide ◽  
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.

Genetic variants in the TLR‐related pathway and smoking exposure alter the upper airway microbiota in adult asthmatic patients

Allergy ◽  
2021 ◽  
Author(s):  
Purevsuren Losol ◽  
Sae‐Hoon Kim ◽  
Soyeon Ahn ◽  
Sejoon Lee ◽  
Jun‐Pyo Choi ◽  
...  
Keyword(s):  
Genetic Variants ◽  
Upper Airway ◽  
Asthmatic Patients ◽  
Smoking Exposure ◽  
Adult Asthmatic ◽  
Related Pathway
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