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Acute severe asthma.
1Center for Academic Clinical Research, Case Western Reserve University School of Medicine, Cleveland, OH, USA. erm2@po.cwru.edu
American Journal of Respiratory and Critical Care Medicine
|October 3, 2003
Summary
Acute severe asthma poses a significant health burden. While most patients recover, a subset requires intensive care, and near-fatal events have poor long-term outcomes, necessitating improved treatments.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Public Health
Background:
- Acute severe asthma is a significant cause of morbidity and mortality.
- While overall mortality is low, intensive care unit (ICU) admissions and mechanical ventilation carry higher risks.
- Socioeconomic factors and ethnicity influence asthma outcomes.
Purpose of the Study:
- To review the natural history, treatment challenges, and outcomes of acute severe asthma.
- To highlight the unmet needs in managing patients resistant to standard emergency department care.
- To emphasize the poor prognosis following near-fatal asthma exacerbations.
Main Methods:
- Review of existing literature on acute severe asthma.
- Analysis of outcomes in emergency departments and medical intensive care units.
- Discussion of current therapeutic strategies and their limitations.
Main Results:
- Most emergency department patients improve within 2 hours with standard care.
- Approximately 30% of ICU admissions require mechanical ventilation, with an 8% mortality rate.
- A significant portion of patients are resistant to standard adrenergic agonists, requiring prolonged treatment and improved therapies.
Conclusions:
- Standard care is effective for most, but challenges remain for resistant cases.
- Near-fatal asthma episodes are associated with poor long-term prognosis and increased mortality.
- Novel therapeutic approaches are needed for severe asthma cases resistant to current treatments.