The profile of ICU admissions for acute severe asthma in a general hospital

The clinical profile of 22 patients admitted to the Intensive Care Unit of Alexandra Hospital over a 2-year period was studied. The mean age was 48.8 years with a majority in the older age group. The attacks leading to admission were generally rapid in evolution with 59% having symptoms for less than 12 hours and 84% for less than 24 hours. Most had a history of severe asthma, and of long duration. The pre-admission therapy had been suboptimal in the majority. Severe respiratory acidosis was a predominant feature. 68% were transferred to the ICU within one hour of arrival at hospital. Mechanical ventilation was required in 86.4% of cases, but the duration of ventilation was usually short. There was no serious complication due to barotrauma. Overall mortality was 23% (5/22). Problems in patient education remain a major hurdle in our attempt to reduce asthma mortality.