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Bronchial hyperresponsiveness following acute severe asthma

A Rabbat1, J P Laaban, E Orvoën-Frija

  • 1Department of Pneumology and Intensive Care, Hôtel-Dieu Hospital, Paris, France.

Intensive Care Medicine
|June 1, 1996
PubMed
Summary

Bronchial hyperresponsiveness (BHR) is severe in patients recovering from acute severe asthma (ASA), even without symptoms. Measuring BHR early after an asthma attack is safe and can identify persistent airway hyperresponsiveness.

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Area of Science:

  • Pulmonology
  • Respiratory Medicine
  • Clinical Immunology

Background:

  • Acute severe asthma (ASA) is a critical condition requiring intensive care unit (ICU) admission.
  • Post-ASA recovery is characterized by persistent airway inflammation and hyperresponsiveness.
  • Assessing bronchial hyperresponsiveness (BHR) early after ASA is crucial for understanding long-term outcomes.

Purpose of the Study:

  • To evaluate bronchial hyperresponsiveness (BHR) in patients who have recovered from acute severe asthma (ASA).
  • To determine the safety and feasibility of BHR measurement shortly after ICU discharge for ASA.
  • To compare BHR levels in post-ASA patients with those in stable asthma patients.

Main Methods:

  • A prospective study involving 41 consecutive patients admitted to the ICU for ASA.

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  • Respiratory function tests, including BHR assessment using acetylcholine challenge, were performed approximately 10 days post-ICU admission.
  • Results were compared to a matched control group of patients with stable asthma.

    • Main Results:

    • BHR measurement was safely performed in 26 out of 41 post-ASA patients.
    • Patients recovering from ASA demonstrated significantly lower PD AC values, indicating more severe BHR, compared to controls.
    • 18 post-ASA patients exhibited very severe BHR, which was not observed in the control group.

    Conclusions:

    • BHR measurement is a safe procedure in the early recovery phase after ASA, provided it is conducted cautiously.
    • Patients clinically free of symptoms and significant obstruction post-ASA often exhibit severe BHR.
    • Early BHR assessment can identify persistent airway hyperresponsiveness, guiding further management strategies.