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The asthmatic state is the most severe form of bronchial asthma. An asthmatic condition is a life-threatening condition as it can lead to severe respiratory failure and, consequently, death. What are the causes and symptoms of my asthmatic condition? What is first aid and treatment?

Asthmatic statusis an exacerbation of bronchial asthma that persists despite optimal treatment for more than one hour and can lead to severe respiratory failure and death.¹ Some researchers also include a bronchospasm as a result of exacerbation of chronic obstructive pulmonary disease (COPD) in the definition of asthmatic state.

The asthmatic state is otherwise acute severe asthma, life-threatening asthma, asthma almost fatal.

The asthmatic state should be distinguished from an attack (attack) of bronchial asthma. A classic attack of bronchial asthma is a sudden onset of breathlessness that may occur suddenly during the remission of the disease or as a result of systematically worsening bronchial constriction. The severity of an attack can vary from mild obstruction to severe respiratory failure, which is life-threatening. This condition requires quick, precise patient assessment and appropriate treatment. The asthmatic state is an emergency and is always a threat to the patient's life. Requires evaluation and treatment by an experienced physician to prevent serious complications or death .¹

Asthmatic state - causes and risk factors

  • insufficient treatment (treatment is not adjusted to the patient's condition in the period preceding the onset of the asthmatic condition)
  • exposure to home and environmental allergen
  • respiratory infection (mostly viral)

1-2 percent (and some sources say that 3%) cases of the asthmatic state cannot be brought under control and despite the most professional care, patients die .¹

  • air pollution
  • contact with toxic and irritating substances
  • atmospheric conditions (temperature and air humidity)
  • drugs (aspirin, non-steroidal anti-inflammatory drugs, β-blockers, ACE inhibitors)
  • excessive emotional tension

For other factorsdifficulties in controlling asthma and increasing the likelihood of developing an asthmatic state include: ¹

  • very young ages
  • severe paranasal sinusitis
  • acid reflux disease
  • relative immunoglobulin deficiencies
  • hyperthyroidism
  • hormonal disorders (pregnancy, menopause)
  • breathing disorders during sleep

Asthmatic state - symptoms

The symptoms preceding the onset of an asthmatic state are as follows: ²

In most cases, your asthmatic state will develop gradually over the course of days and weeks (but sometimes your breathlessness will increase significantly within minutes and hours).

  • more frequent shortness of breath
  • no improvement despite increasing the doses of drugs
  • nighttime shortness of breath appears (if it has not happened so far), exertional dyspnea increases
  • irritation and anxiety
  • cough appears or intensifies, coughing up sometimes discolored secretion

The symptoms of the asthmatic stateare:

  • orthopne, i.e. the patient, due to increased breathlessness, takes a standing position and rests his hands on an object (e.g. a window sill, a piece of furniture), which makes it easier for him to breathe
  • breathing rate increase (over 25 / min)
  • whistles heard from a distance, often accompanied by cyanosis, especially of the face
  • Inability to say a short sentence on a single exhalation (a simple way to judge is to ask the patient to count to 10, patients with severe breathlessness are unable to utter a few words without gasping for breath)
  • absent or dry, jerky cough, later with expectoration of a large amount of sputum
  • increased heart rate (often over 120 / min)
  • tightening the extra expiratory muscles
  • Characteristic sitting position of the patient, bent forward, leaning forward, supported on the arms to create a support point for deep breaths
Worth knowing

The asthmatic state may develop quickly (in 10-20% of patients) or slowly (in 80-90% of patients). In the first case, symptoms develop in less than 6 hours. This reaction is mainly caused by allergens, exercise or stressful situations. The response to treatment is then rapid and hospitalization is rarely required. In the latter case, infection is the most common cause of the asthmatic condition. It takes longer than 6 hours (mostly days) to develop symptoms and to respond more slowly to treatment. Hospitalization is also necessary¹

Asthmatic state -what to do? First aid in an asthmatic condition

The asthmatic state is a life-threatening condition. The sick person must be hospitalized as soon as possible. While waiting for the emergency room or transport to the hospital, the patient should be calmed down (stress additionally increases breathlessness), ensure a comfortable position, You can also unbutton your clothes and remove any ornaments that press on the neck (loosen the tie, take off the scarf).

Asthmatic status - diagnosis

The doctor finds wheezing after putting the earpiece to the chest, increased heart rate, increased blood pressure. PEF (Peak Expiratory Flow) measurements are also made.

Asthmatic state - treatment

The treatment of the asthmatic state should be started as soon as possible and should be carried out strictly in a hospital setting. It is a comprehensive treatment and includes: ²

  • oxygen therapy
  • bronchodilators
  • steroids
  • correction of water-electrolyte and acid-base disturbances
  • antibiotic therapy in case of infection

Maintaining the correct dosage of drugs and conducting precise monitoring of patients guarantees remission of the asthmatic state. Sometimes, however, despite the correct procedure, it comes to a state in which intubation and mechanical ventilation are the only chance to save the patient .¹

Bibliography:

1. Karwat K., Asthmatic state - how to recognize and treat? "Therapy" 2008

2. Kulesza-Kazecka M., Asthmatic condition in children, "Nowa Pediatria" 2002, No. 4

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Category:

Respiratory system