Status Asthmaticus Questions & Answers

Updated: Jun 17, 2020
  • Author: Constantine K Saadeh, MD; Chief Editor: John J Oppenheimer, MD  more...
  • Print
Questions & Answers

Overview

What is status asthmaticus?

What is the role of patient education in the prevention of status asthmaticus recurrence?

What is status asthmaticus?

What are symptoms of status asthmaticus?

What is the clinical presentation of status asthmaticus?

What has led to a decline in ICU admissions for status asthmaticus?

What are goals of management for status asthmaticus?

What causes status asthmaticus?

What are the 2 phases of the pathogenesis of status asthmaticus?

What is the role of the immune system in the pathogenesis of status asthmaticus?

What is the inflammatory response in the pathogenesis of status asthmaticus?

What causes increased airway resistance and obstruction in the pathogenesis of status asthmaticus?

What causes hyperventilation in the early stages of status asthmaticus?

What type of factors increase the risk for status asthmaticus?

How is gastroesophageal reflux diseases (GERD) a risk factor for status asthmaticus?

What are risk factors for status asthmaticus?

What is the prevalence of status asthmaticus in the US?

What is the global incidence of status asthmaticus?

What are the demographic predilections of status asthmaticus in the US?

What is the prognosis of status asthmaticus?

What are complications of status asthmaticus?

What causes pneumothorax in status asthmaticus?

What is the mortality rate for status asthmaticus?

What are the risks of mortality for status asthmaticus?

What is the importance of patient education for status asthmaticus?

Presentation

How does status asthmaticus frequently present?

What should be the focus of history in suspected status asthmaticus?

What are the risk factors for developing severe or persistent status asthmaticus?

What does the absence of wheezing suggest in status asthmaticus?

What is the progression of consciousness in patients with status asthmaticus?

What are the initial physical findings in status asthmaticus?

What blood pressure is characteristic of status asthmaticus?

Which physical findings are characteristic of later stages of status asthmaticus?

What is the role of peak flow rate in the evaluation of status asthmaticus?

What is the significance of a finding retractions and abdominal muscle usage in status asthmaticus?

What are cardiovascular symptoms of status asthmaticus?

What are the central nervous system (CNS) signs and symptoms of status asthmaticus?

Why does wheezing occur in status asthmaticus?

What does auscultation reveal in status asthmaticus?

What are the signs associated with pneumothorax in status asthmaticus?

What causes abdominal pain in moderate to severe status asthmaticus?

What causes pulsus paradoxus in status asthmaticus?

DDX

What can lead to misdiagnosis of status asthmaticus?

What are the differential diagnoses for Status Asthmaticus?

Workup

What is the role of lab testing in the diagnosis of status asthmaticus?

What is the role of chest radiography in the diagnosis of status asthmaticus?

When is chest radiography indicated for the diagnosis of status asthmaticus?

What is the role of a CBC count and differential in the diagnosis of status asthmaticus?

How is an arterial blood gas (ABG) value used in the diagnosis of status asthmaticus?

When are arterial blood gas (ABG) determinations indicated in the diagnosis of status asthmaticus?

What are the stages of blood gas progression in status asthmaticus?

How are serum electrolyte levels used in the diagnosis of status asthmaticus?

How are serum glucose levels used in the diagnosis of status asthmaticus?

What is the role of blood theophylline measurement in the diagnosis of status asthmaticus?

When should serum theophylline be measured in patients with suspected status asthmaticus?

What are the factors that decrease theophylline clearance in status asthmaticus?

What are the factors that increase theophylline clearance in status asthmaticus?

What is the role of peak expiratory flow (PEF) measurement in the evaluation of status asthmaticus?

When is hospitalization indicated for the treatment of status asthmaticus?

What is the role of forced expiratory volume (FEV1) testing in the evaluation of status asthmaticus?

What is the role of spirometry in the evaluation of status asthmaticus?

What is the role of pulse oximetry in the diagnosis of status asthmaticus?

What are the advantages of pulse oximetry for the diagnosis of status asthmaticus?

What are the disadvantages of pulse oximetry for the diagnosis of status asthmaticus?

Which pulmonary function testing for status asthmaticus require body plethysmography?

What is the purpose of impulse oscillometry testing for the diagnosis of status asthmaticus?

How can impulse oscillometry results be used to educate patients with status asthmaticus?

How is oscillation testing performed with an impulse oscillometry system (IOS) to evaluation status asthmaticus?

What is required for the measurement of airflow resistance in the evaluation of status asthmaticus?

What is the significance of bronchospasms and increased airway resistance during oscillation testing for status asthmaticus?

What is the significance of peripheral airway inflammation in status asthmaticus?

How can acute dyspnea affect the accuracy of oscillometry testing for status asthmaticus?

Which histologic findings suggest status asthmaticus?

What is the basis for staging status asthmaticus?

When is admission to the ICU indicated for status asthmaticus?

What are characteristics of stage 1 status asthmaticus?

What are characteristics of stage 2 status asthmaticus?

What are characteristics of stage 3 status asthmaticus?

What are characteristics of stage 4 status asthmaticus?

Treatment

What are treatment options for control of bronchoconstriction and inflammation in status asthmaticus?

How is fluid replacement used in the treatment of status asthmaticus?

How are antibiotics used to treat status asthmaticus?

How are oxygen levels monitored in patients with status asthmaticus?

How is oxygen therapy administered in status asthmaticus?

When is chest tube placement indicated in the treatment of status asthmaticus?

What is the role of nitrate oxide therapy in the treatment of status asthmaticus?

What is the role of leukotriene modifiers in the treatment of status asthmaticus?

What are the indications for ICU admission for status asthmaticus?

When is thoracostomy indicated in the treatment of status asthmaticus?

What are the treatment options for status asthmaticus exacerbated by gastroesophageal reflux disease (GERD)?

When is anesthesia support needed in the treatment of status asthmaticus?

When should treatment of status asthmaticus take place at a specialized center?

When is consultation with a nutritionist indicated in the treatment of status asthmaticus?

What is the first line of therapy for status asthmaticus?

How is albuterol administered for the treatment of status asthmaticus?

What is the role of levalbuterol in the treatment of status asthmaticus?

Which drugs are safe for the treatment of status asthmaticus during pregnancy?

What is the most effective route of delivery for beta2-agonists in the treatment of status asthmaticus?

When are beta-agonists most effective in the treatment of status asthmaticus?

What is the role of endotracheal adrenaline in the treatment of status asthmaticus?

What are possible adverse effects of continuous administration of inhaled albuterol and IV methyl prednisolone in the treatment of status asthmaticus?

What are the advantages of higher dose albuterol for the treatment of status asthmaticus?

What is the role of nonselective beta2-agonists for the treatment of status asthmaticus?

Why is IV isoproterenol contraindicated in the treatment of status asthmaticus?

What is the role of cardiac enzyme level monitoring in the treatment of status asthmaticus?

What is the role of anticholinergics in the treatment of status asthmaticus?

What is the role of ipratropium bromide (Atrovent) in the treatment of status asthmaticus?

What are the risks of atropine in the treatment of status asthmaticus?

What is the role do glucocorticosteroids in the treatment of status asthmaticus?

How are glucocorticosteroids administered in the treatment of status asthmaticus?

How long does it take for corticosteroid therapy to become effective in the treatment of status asthmaticus?

What is the role of methylprednisolone in the treatment of status asthmaticus?

What monitoring is needed during corticosteroid treatment of status asthmaticus?

What are adverse effects of pulse therapy for the treatment of status asthmaticus?

What is the efficacy of budesonide compared to prednisone for the treatment of status asthmaticus?

When are nebulized steroids contraindicated in the treatment of status asthmaticus?

What is the role of methylxanthines in the treatment of status asthmaticus?

What is benefit of IV theophylline in the treatment of status asthmaticus?

What are the effects of theophylline in the treatment of status asthmaticus?

How is theophylline administered for the treatment of status asthmaticus?

What are theophylline therapeutic levels for the treatment of status asthmaticus?

Which drug interactions should be considered when using theophylline for the treatment of status asthmaticus?

How are theophylline doses managed in patients with status asthmaticus who smoke?

What is the role of aminophylline in the treatment of status asthmaticus?

What is the role of magnesium sulfate in the treatment of status asthmaticus?

What is the efficacy of magnesium sulfate for the treatment of status asthmaticus?

What is the role of inhaled magnesium for the treatment of status asthmaticus?

What is the role of sedatives in the treatment of status asthmaticus?

What is the role of ketamine in the treatment of status asthmaticus?

What is the role of inhaled anesthetic agents in the treatment of status asthmaticus?

What is the most common inhaled analgesic used in the treatment of status asthmaticus?

What is the role of neuromuscular blockers in the treatment of status asthmaticus?

What is the role of nitric oxide in the treatment of status asthmaticus?

What is the role of lidocaine in the treatment of status asthmaticus?

When is extracorporeal life support indicated in the treatment of status asthmaticus?

What is the role of extracorporeal life support in the treatment of status asthmaticus?

When is noninvasive ventilation indicated in the treatment of status asthmaticus?

What is the effectiveness of noninvasive ventilation for the treatment of status asthmaticus?

What is the efficacy of venoocclusive extracorporeal membrane oxygenation (ECMO) for the treatment of status asthmaticus?

What may decrease adverse effects of noninvasive ventilation for the treatment of status asthmaticus?

In which patient group is noninvasive ventilation the most effective for the treatment of status asthmaticus?

When should mechanical ventilation be considered for the treatment of status asthmaticus?

What are the indications for intubation and mechanical ventilation in the treatment of status asthmaticus?

How long is mechanical ventilation required for the treatment of status asthmaticus?

What are possible adverse effects of mechanical ventilation for the treatment of status asthmaticus?

What is the role of controlled hypoventilation in the treatment of status asthmaticus?

What is the role of positive end-expiratory pressure (PEEP) in the treatment of status asthmaticus?

Which type of mechanical ventilation has been used to treat status asthmaticus?

Which type of mechanical ventilation has been used to treat children with status asthmaticus?

What are limitations of invasive mechanical ventilation for the treatment of status asthmaticus?

What needs to be monitored in patients receiving mechanical ventilation for the treatment of status asthmaticus?

When is a catheter indicated for the treatment of status asthmaticus?

What is the role of heliox in the treatment of status asthmaticus?

How is heliox used in the treatment of status asthmaticus?

What are the benefits of heliox administered nebulized treatments for status asthmaticus?

How is heliox administered for the treatment of status asthmaticus?

What are the limitations of heliox for the treatment of status asthmaticus?

What is the goal of heliox with mechanical ventilation for the treatment of status asthmaticus?

When should the use of heliox be considered for the treatment of status asthmaticus?

How is status asthmaticus prevented?

What can aid the prevention of status asthmaticus?

What are the prophylactic medications for status asthmaticus?

What are the risk factors for recurrent status asthmaticus?

What are the benefits of inpatient education for status asthmaticus?

Which specialists should be consulted in the treatment of status asthmaticus?

How can hospitalization for status asthmaticus be prevented?

Who should be consulted in the treatment of adolescents with status asthmaticus?

What should be included in the follow-up after treatment of status asthmaticus?

How are children with status asthmaticus monitored following treatment?

What is included in the outpatient follow-up of status asthmaticus?

What are the complications of status asthmaticus?

Guidelines

What are the guidelines for managing status asthmaticus?

How does adherence to the National Heart-Lung and Blood Institute asthma guidelines reduce the incidence of status asthmaticus?

Medications

Which medications are used in the pharmacologic treatment of status asthmaticus?

What is the role of enoximone in the treatment of status asthmaticus?

Which medications in the drug class Pulmonary, Other are used in the treatment of Status Asthmaticus?

Which medications in the drug class Xanthine Derivatives are used in the treatment of Status Asthmaticus?

Which medications in the drug class Corticosteroids are used in the treatment of Status Asthmaticus?

Which medications in the drug class Anticholinergic, Respiratory are used in the treatment of Status Asthmaticus?

Which medications in the drug class Beta2-Agonist are used in the treatment of Status Asthmaticus?