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Severe asthma

K H Lee1, W C Tan, T K Lim

  • 1Department of Medicine, National University Hospital, Singapore.

Singapore Medical Journal
|June 1, 1997
PubMed
Summary
This summary is machine-generated.

Severe asthma requiring intensive care has a significant mortality rate, with hypercapnia not always necessitating mechanical ventilation. Long-term survival is generally good for those who recover from the acute episode.

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Area of Science:

  • Pulmonology
  • Critical Care Medicine
  • Epidemiology

Background:

  • Severe asthma exacerbations can necessitate intensive care unit (ICU) admission.
  • Understanding the outcomes of severe asthma in the ICU is crucial for resource allocation and patient management.

Purpose of the Study:

  • To determine the morbidity and mortality rates associated with severe asthma requiring intensive care in Singapore.
  • To identify factors influencing outcomes in these critically ill patients.

Main Methods:

  • Retrospective review of 49 admissions for severe asthma to a medical intensive care unit between January 1987 and March 1993.
  • Analysis of patient demographics, clinical course, interventions (including mechanical ventilation), and outcomes.

Main Results:

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  • The study identified 48 patients with 49 admissions for severe asthma requiring ICU care.
  • Cardiorespiratory arrest occurred in 33% of cases, with half surviving with hypoxic brain damage. Mechanical ventilation was required in 61% of patients.
  • Hospital mortality was 12%, with an additional 5% mortality shortly after discharge. Mortality was not predicted by prior ventilation, asthma duration, or age.

Conclusions:

  • Severe asthma carries a substantial mortality risk, even with intensive care.
  • Hypercapnia (elevated CO2 levels) did not consistently predict the need for mechanical ventilation.
  • Long-term survival for patients recovering from acute severe asthma was favorable, with only one death among 40 survivors over a 2-year follow-up.