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[Bronchial asthma: clinico-pathological study of fatalities in intensive care units]
Abstract:
Due to the great amount of asthmatic patients presenting complications which could endanger their lives, a revision of the possible threatening factors is carried out. The factors concurring with the base pathologic mechanism are analyzed and it is demonstrated, that some of these factors intervene independently from bronchial asthma. The study is carried out on the basis of age, sex, hospital stay duration, clinical picture, blood gases analysis, complications and pathology findings: 1) Most of the deceased patients presented various pathologies besides bronchial asthma which contributed to the decease. 2) The physician should be alert in order to establish good therapeutic procedure in these patients which could carry other important complications; these complications are responsible for the fatal outcome in a great number of patients. A complication should always be searched for, e.g. pneumothorax. 3) The vast majority of patients who passed away in status were relatively young. 4) A female predominance was found. 5) All patients before entering our Center, presented asthma crisis at least three days prior to admission. 6) The predominant hospital stay duration was 24 hours. 7) The most common pathologic findings were: pulmonary fibroemphysema, acute bronchopneumonia, bronchial mucoid plugging, atelectasia and cerebral edema. 8) Cerebral edema and compression of the amygdale were common brain pathologic findings. 9) Bronchopneumonia was a common necropsy finding. 10) Based on these findings, ICU treatment is extremely important. 11) The critical status of the patient in the moment of admission, is due to the delay in bringing him to the hospital for proper medical surveyance. This justifies the interest of the Public Health Department in ample distribution of proper information to the asthmatic patients.