Plasma cortisol and the use of hydrocortisone in the treatment of status asthmaticus.

Cayton, R. M., and Howard, P. (1973). Thorax, 28, 567-573. Plasma cortisol and the use of hydrocortisone in the treatment of status asthmaticus. Plasma cortisol, intravenous synacthen tests of adrenal function, arterial blood gases, and spirometric tests of respiratory function were measured in patients with bronchial asthma during clinically stable periods and during status asthmaticus. Intravenous hydrocortisone was given in a predetermined manner in an attempt to measure the effective dose for treatment. The presence of adrenal suppression did not influence the severity of the attack nor the amount of hydrocortisone required for treatment. Clinical signs, arterial oxygen tension, forced expiratory volume, forced vital capacity, pulse rate, and blood pressure gave no indication as to which patients would respond to a single injection of aminophylline or require repeated hydrocortisone for days or weeks. The results are discussed in relation to the mechanism of bronchial asthma.