Cellular events that occur in status asthmaticus (SA) remain poorly investigated. Autopsy studies frequently emphasized about the presence of eosinophils in bronchial airway wall, whereas recent studies reported increased number of neutrophils in patients dying of sudden-onset fatal asthma. Mucus plugs occluding the bronchial lumen are almost constant features during SA. Bronchial lavage (BL) m...

Acute asthma exacerbations occur relatively frequently in children. We present the case of a 4-year-old boy who was admitted to our hospital in status asthmaticus and found to have a wide complex rhythm while being treated with inhaled albuterol and intravenous methylprednisolone. This rhythm was diagnosed as accelerated idioventricular rhythm (AIVR), which carries a benign prognosis. It resolv...

Leakage of air into the interstitial tissues of the lungs of sufficient degree to produce pneumomediastinum and subcutaneous emphysema is an uncommon and potentially fatal complication of bronchial asthma in childhood. Another possibly fatal complication of similar causation is tension pneumothorax. It is possible that interstitial emphysema occurs more frequently in severe asthma and allied st...

A 25-year old female, with a background of asthma, presented with acute shortness of breath. On examination the patient was in severe respiratory distress with expiratory wheezes. She was nebulized with ipratropium and fenoterol. A chest x-ray revealed pseudodextrocardia and air trapping (A). She did not respond to inhaled bronchodilator therapy. Intravenous hydrocortisone and magnesium sulphat...

Despite advancing knowledge of the pathophysiology and treatment of asthma, asthma morbidity and mortality are on the rise. To help avert this trend, clinicians and patients must focus their attention on the early identification and treatment of asthma exacerbations. As in the words of Dr. Thomas Petty: " ... the best treatment of status asthmaticus is to treat it three days before it occurs." ...

OBJECTIVE To present a clinical approach to the management of acute asthma and the life threatening episode of asthma. DATA SOURCES A review of published peer-review articles and studies reported from 1966 to 1999 and identified through a MEDLINE search on the management of acute asthma, status asthmaticus and acute fulminant asthma. SUMMARY OF REVIEW Asthma is a disease caused by a chronic...