What is status asthmaticus?

Status asthmaticus is a medical emergency, an extreme form of asthma exacerbation characterized by hypoxemia, hypercarbia, and secondary respiratory failure.

What is a favorable response to initial treatment of Status asthmaticus?

A favorable response to initial treatment of status asthmaticus should be a visible improvement in symptoms that sustains 30 minutes or beyond the last bronchodilator dose and a PEFR greater than 70% of predicted.

Why are some patients with Status asthmaticus unresponsive to padrenergic agonists?

Many patients with status asthmaticus are unresponsive to the beneficial effects of padrenergic agonists. The mechanism of unresponsiveness is not understood, although it may relate to abnormal receptor function or a decreased population of β-receptors resulting from previous adrenergic therapy.

When should a patient with Status asthmaticus be intubated?

The decision to intubate a patient presenting with status asthmaticus is a clinical one and does not unequivocally require a blood gas assessment. If a patient continues to deteriorate despite initial pharmacologic treatment, a bedside assessment around the time window of response needs to be made.

Which nursing diagnoses are applicable to patients with Status asthmaticus?

The following nursing diagnoses are applicable to patients with Status Asthmaticus: Ineffective Airway Clearance related to bronchospasms and increased pulmonary secretions. Fear related to breathlessness and recurrences

How is excessive dynamic airway collapse diagnosed in status asthmaticus (SA)?

Recurrent presentation with status asthmaticus resolved with positive pressure ventilation, particularly in adults, should raise suspicion for excessive dynamic airway collapse (EDAC), confirmed by bronchoscopy or laryngoscopy in a controlled setting.

What are the mortality and morbidity associated with Status asthmaticus?

An estimated 3% to 16% of hospitalized adult asthmatic patients progress to respiratory failure requiring ventilatory support, although the statistics might be lower in children. Afessa et al. have reported a mortality of around 10% in the intensive care unit (ICU) patients admitted with status asthmaticus.