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post in: Lifestyle Date:10 Oct 2017, 04:58 views:4950
See also: Chronic Obstructive Pulmonary Disease written for asthma patients.
When the diagnosis of asthma is confirmed and comorbidities addressed, severe asthma is defined as asthma that requires treatment with high-dose inhaled corticosteroids (ICS) plus a second controller and/or systemic corticosteroids to prevent it from becoming 'uncontrolled or that remains asthma 'uncontrolled' despite this therapy. Asthma is a common disease and its frequency sometimes detracts from its potential seriousness. In adults with asthma, only 5-10 have severe disease but these individuals carry a substantial proportion of the cost (both in terms of morbidity and economic consideration) and run the highest risk of acute severe exacerbations and death.
Status asthmaticus is severe asthma that does not respond well to immediate care and is a life-threatening medical emergency.
Ensuing respiratory failure results in hypoxia, carbon dioxide retention and acidosis. The exact mechanism underlying the development of an acute severe asthma attack remains elusive but there appear to be two phenotypes 3, 4 : Gradual-onset - in about 80, severe attacks develop over more than 48 hours.
These are associated with eosinophilic infiltration and slow response to therapy. Sudden-onset - often in association with significant allergen exposure.
Patients tend to be older and to present between midnight and. This type of attack is associated with neutrophilic inflammation and a swifter response to therapy.allergy
In deaths from asthma there is often a failure to recognise the full severity of the situation. This can be down to the patient, their family/carers or the healthcare team but often a multitude of factors is involved.
Patients frequently have adverse psychosocial factors that interact with the ability to judge or manage their disease or have a diminished perception of their dyspnoea that leads to late presentation. Medical care continues to fail sometimes to treat acute severe asthma aggressively enough or to comply with national guidelines.
Every emergency consultation for asthma should be regarded as for acute severe asthma* until proven otherwise. All patients with acute severe asthma* that has not responded to immediate treatment or life-threatening asthma* must be referred to hospital. see below for clinical features, there were 1,167 deaths from asthma in the UK in 2011.