Status asthmaticus, severe acute asthma or severe exacerbation of asthma

"Status Asthmaticus" is an old term which has been defined in many different ways. Two distinctive features are usually used to identify "Status Asthmaticus": severity and lack of response to bronchodilators. However, the latter condition is not always observed and thus the term "Status Asthmaticus" basically implies severity. "Severe acute asthma" is a new term which has replaced "Status Asthmaticus". Nevertheless, a severe attack of asthma may occur suddenly or can take place after days or weeks of a progressive deterioration. A "Status Asthmaticus" can be "acute" or "subacute" according to the rate of deterioration; therefore the term "Severe acute asthma" is misleading. Since the term "Status Asthmaticus" essentially implies severity, severe attacks would be better described as "Severe exacerbation of asthma" (SEA). Classification of the SEA into two types (acute and subacute), could help to reveal the etiology of the attack and might also be relevant to the management of the patient. For instance an acute SEA can be seen in brittle asthma and in patients with aspirin intolerance. On the other hand, patients with the subacute form are refractory to bronchodilators and must be treated with corticosteroids.