Status Asthmaticus – StatPearls – NCBI Bookshelf Status asthmaticus is a medical emergency, an extreme form of asthma exacerbation characterized by hypoxemia, hypercarbia, and secondary respiratory failure.
What is the drug of choice for Status asthmaticus?
Theophylline. Theophylline has been used as a bronchodilator for over 50 years and is still a mainstay of drug treatment for status asthmaticus. 14 The mechanism of action of theophylline is thought to be inhibition of phosphodiesterase, resulting in an increase in intracellular cyclic AMP associated with bronchial smooth muscle relaxation.
How do you treat status asthmaticus with helium?
The same gas used to inflate balloons can help treat status asthmaticus. Inhaled helium with oxygen (heliox) can help to reduce turbulent airflow in the lungs. A person can breathe heliox via a mask. They can also receive heliox therapy at the same time as receiving albuterol.
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When is mechanical ventilation indicated in the treatment of Status asthmaticus?
Consider mechanical ventilation as a salvage therapy in patients with status asthmaticus. Mechanical ventilation in patients with asthma requires careful monitoring, because these patients have high end-expiratory pressure and, therefore, are at high risk for pneumothorax.
What is the role of beta-agonists in the treatment of Status asthmaticus?
Beta-agonists are generally most effective in the early asthma reaction phase. However, patients who present with status asthmaticus despite frequent use of beta-agonists at home may have tachyphylaxis and may exhibit resistance to these agents.
Can montelukast be used in the emergency department for Status asthmaticus?
There has been one study that showed minimal to no effect of using montelukast in the emergency department setting for patients with status asthmaticus. [ 21, 22] In general, it did not show any significant benefit. It is not used specifically for status asthmaticus prevention. Indications for ICU admission include the following:
What is the Pulsus paradoxus in status asthmaticus?
Pulsus paradoxus is the difference between end-expiratory and end-inspiratory systolic blood pressure. It is augmented to more than 12 mm Hg in status asthmaticus, although it may paradoxically decline in late-stage with increasing fatigability and loss of respiratory drive.
What are the benefits of ketamine for Status asthmaticus?
Ideally, this can help prevent hypoxia in a person with status asthmaticus. Doctors may use this medication in anesthesia. It has the beneficial effect of bronchodilation, or opening of the airways. Because ketamine has sedating properties, a doctor will usually only prescribe it if a person does not respond to other therapies.
