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[Acute severe asthma in older adults]
G Schultze-Werninghaus1, H W Duchna, K Rasche
1Medizinische Klinik III, Berufsgenossenschaftliche Kliniken Bergmannsheil, Klinikum der Ruhr-Universität Bochum. gerhard.schultze-werninghaus@rub.de
Der Internist
|April 1, 2004
Summary
Severe asthma is primarily caused by viral infections or Mycoplasma pneumoniae, not bacteria. Treatment involves oxygen, beta-agonists, and steroids, with mechanical ventilation and bronchoscopy for critical cases.
Area of Science:
- Pulmonology
- Infectious Diseases
- Critical Care Medicine
Context:
- Acute severe or life-threatening asthma necessitates understanding its diverse triggers.
- Identifying underlying causes is crucial for effective management.
- Recognizing factors beyond bacterial infections is key.
Purpose:
- To outline the primary causes of severe asthma exacerbations.
- To detail appropriate therapeutic strategies for acute asthma.
- To describe advanced interventions for respiratory failure in asthma.
Summary:
- Infections with respiratory viruses or Mycoplasma pneumoniae are the main drivers of severe asthma, contrasting with bacterial infections.
- Standard outpatient treatment includes high-flow oxygen, high-dose beta-agonists, and systemic glucocorticosteroids.
- Hospitalized patients may require intravenous therapy, mechanical ventilation (with permissive hypercarbia), bronchoscopy, and bronchial lavage for severe respiratory compromise.
Impact:
- Provides a clear diagnostic and therapeutic pathway for managing severe asthma exacerbations.
- Highlights the importance of non-bacterial triggers in severe asthma.
- Informs clinical practice regarding advanced respiratory support and interventions in critical asthma cases.