acute severe asthma

(status asthmaticus, severe asthma exacerbation)
Severe asthma unresponsive to repeated courses of beta-agonist therapy such as inhaled albuterol, levalbuterol, or subcutaneous epinephrine.
It is a medical emergency that requires immediate recognition and treatment.
The patient history should be focused including current use of oral or inhaled corticosteroids, number of hospitalizations, etc.
Oral or parenteral corticosteroids should be administered as early as possible because clinical benefits may not occur for a minimum of 6-12 hours.
Causes:
- Upper respiratory infections (50% of occurrences).
- Medical nonadherence (not taking medications correctly), insufficient use of inhaled or oral corticosteroids.
- Allergen exposure (especially pets) in severely atopic individuals, irritant inhalation (smoke, paint, etc.), nonsteroidal anti-inflammatory exposure in aspirin-allergic patients.
- Exercise.
Cf. asthma attack