A new look at adult asthma
Intensive Care Unit and Clinical Research Laboratory, Whiston Hospital, Prescot, Merseyside UKBritish Journal of Diseases of the Chest 02/1982; 76(1):11-4. DOI: 10.1016/0007-0971(82)90002-X
Understanding of the natural history of asthma is hampered by the lack of precise definitions. A new definition of severe acute asthma is proposed with primary emphasis on the circulatory disturbances. The natural history of severe acute asthma and the value of steroid therapy are re-examined in the light of the new definition.
Article: Status asthmaticus in adults[Show abstract] [Hide abstract]
ABSTRACT: Status asthmaticus is a severe, life-threatening exacerbation of bronchial asthma that fails to improve with "conventional" treatment. "Conventional" treatment has been defined as three subcutaneous injections of epinephrine given at 15-min intervals. The use of the term "status asthmaticus" has value in that it has simplified communication. However, it has the disadvantages that it is too restrictive. It draws attention away from other aspects of severe asthma; for example, that patients die at home L2 and, in some cases, within minutes of the onset of an attack/'3 It is probably more useful to talk of "severe acute asthma," rather than "status asthmaticus. "4 Between 1959 and 1979, the overall mortality due to asthma in patients from 5 to 34 years of age ranged from 0.2 to 4.1 deaths per 100,000 persons. In the United States and Canada, mortality was fairly constant, being between 0.2 and 0.4 deaths per 100,000 persons, s The hospital mortality for severe acute asthma in adult patients is shown in Table 1. The mean mortality is 1.34%. Asthma remains a potentially lethal disease, and its mortality has not declined significantly over the last 20 years.Clinical Reviews in Allergy & Immunology 02/1985; 3(1):69-94. DOI:10.1007/BF02993043 · 5.46 Impact Factor
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ABSTRACT: Sixty patients with acute severe asthma were treated by conventional methods in all respects except for the use of steroids. Patients who were not currently taking systemic steroids (30) received none during the severe attack, and those who were currently taking systemic steroids (30) were given 400 mg hydrocortisone daily. The results were compared to a further group of 30 patients with acute severe asthma of similar severity who were treated in the same hospital by the same methods but with much larger doses of hydrocortisone (1200 mg daily). All 60 patients recovered and the time course, changes in heart rate and peak expiratory flow (PEFR) were similar in all groups. These results suggest that steroids are of doubtful value in the treatment of acute severe asthma and further randomized and controlled trials are required.British Journal of Diseases of the Chest 02/1982; 76(1):15-9. DOI:10.1016/0007-0971(82)90003-1
Article: Acute severe asthma.Journal of the Royal Society of Medicine 03/1982; 75(2):138. · 2.12 Impact Factor
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