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Status Asthmaticus
Robert M. Senior, MD;
Stephen S. Lefrak, MD;
Phillip E. Korenblat, MD
JAMA. 1975;231(12):1277-1279.
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STATUS asthmaticus refers to a life-threatening asthmatic episode that is initially unresponsive to vigorous therapy with epinephrine, aminophylline, aerosolized bronchodilators, and hydration. Status asthmaticus must be distinguished from other causes of wheezing such as pulmonary edema, pulmonary emboli, upper airway obstruction, or an acute exacerbation of bronchitis in the patient with chronic obstructive lung disease.
The asthmatic attack leading to status asthmaticus may involve a variety of processes including partial β-adrenergic blockade, immunological events, and infection, but it is probable that the final event that culminates in status asthmaticus is plugging of the airways with mucus. It is the presence of bronchial casts, rather than "bronchospasm," that accounts in large measure for the refractoriness to bronchodilators as well as the slow return of lung function to normal even after symptoms have abated. At present, little is known about the factors that govern the type and quantity of tracheobronchial mucus in
. . . [Full Text PDF of this Article]
Author Affiliations
From the Department of Medicine, Washington University School of Medicine at the Jewish Hospital of St. Louis. Dr. Senior is the recipient of Pulmonary Academic Award 5 K07 HL70351-03 from the National Heart and Lung Institute.
Footnotes
Reprint requests to the Jewish Hospital of St. Louis, 216 S Kingshighway Blvd, St. Louis, MO 63110 (Dr. Senior).
Coordinated and edited by Samuel Vaisrub, MD, Senior Editor.
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