Related Experiment Video

Updated: Aug 19, 2026

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
14:39

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Published on: November 4, 2010

Cardiovascular response during severe acute asthma and its treatment in children

A T Edmunds, S Godfrey

    Thorax
    |July 1, 1981
    PubMed

    Insights

    In children with status asthmaticus, pulsus paradoxus correlated with PaCO2. Combination therapy with aminophylline and salbutamol improved peak expiratory flow more than aminophylline alone.

    Area of Science:

    • Pediatric Critical Care
    • Respiratory Medicine
    • Cardiovascular Physiology

    Background:

    • Status asthmaticus in children presents significant respiratory and hemodynamic challenges.
    • Transthoracic electrical impedance cardiography (IET) is a non-invasive method to assess hemodynamic parameters.

    Purpose of the Study:

    • To evaluate hemodynamic changes and treatment efficacy in children with status asthmaticus.
    • To investigate the correlation between pulsus paradoxus and blood gas levels.
    • To compare the effects of different treatment regimens on respiratory and hemodynamic parameters.

    Main Methods:

    • Hemodynamic parameters (heart rate, blood pressure, pulsus paradoxus, cardiac output) were measured using IET in 29 children.
    • Patients received oxygen, intravenous fluids, and hydrocortisone.
    • Patients were randomly assigned to receive aminophylline, salbutamol, or both.
    • Changes were monitored over the first two hours of treatment.

    Main Results:

    • Admission pulsus paradoxus correlated significantly with PaCO2 (r=0.66), with values >20 mmHg in patients with PaCO2 >5.5 kPa.
    • Mean stroke volume and cardiac output were 89% and 131% of resting values, respectively.
    • Combination therapy (aminophylline + salbutamol) showed a significantly greater increase in peak expiratory flow (PEF) than aminophylline alone (P<0.05).
    • Nebulized salbutamol was as effective as intravenous salbutamol.
    • Heart rate and systolic blood pressure decreased significantly after nebulized aminophylline and salbutamol, but not with intravenous administration.

    Conclusions:

    • Pulsus paradoxus is a useful indicator of hypercapnia in pediatric status asthmaticus.
    • Combination therapy with aminophylline and salbutamol enhances bronchodilation.
    • Hemodynamic parameters did not significantly change with the administered treatments, suggesting relative cardiovascular stability despite severe asthma exacerbation.

    More Related Videos

    Assessment of Respiratory Function in Conscious Mice by Double-chamber Plethysmography08:58

    Assessment of Respiratory Function in Conscious Mice by Double-chamber Plethysmography

    Published on: July 10, 2018

    A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn11:27

    A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

    Published on: April 7, 2023

    Related Concept Videos

    Adrenergic Agonists: Therapeutic Uses01:30

    Adrenergic Agonists: Therapeutic Uses

    Adrenergic agonists have diverse therapeutic uses across various medical conditions and emergencies.
    Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
    Allergies and anaphylaxis:...
    Adrenergic Antagonists: Pharmacological Actions of &#946;-Receptor Blockers01:27

    Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers

    β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in bronchial smooth...
    Asthma: Pathogenesis and Management01:20

    Asthma: Pathogenesis and Management

    Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
    Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
    Asthma-III: Symptoms and Complications01:24

    Asthma-III: Symptoms and Complications

    Asthma, a common chronic respiratory condition, is classified considering the frequency and severity of symptoms alongside lung function impairment. Understanding this classification is essential for appropriate treatment and management. Here's a detailed look at the classification of asthma and its clinical features and complications:
    Classification of Asthma
    Asthma-IV: Diagnostic and Management01:30

    Asthma-IV: Diagnostic and Management

    The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
    Clinical Assessment for Asthma:
    This is the first step in diagnosing and managing asthma. It includes:
    Asthma III: Clinical Manifestations01:13

    Asthma III: Clinical Manifestations

    Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...