Status asthmaticus

Status asthmaticus is also called Acute severe asthma.

In Status asthmaticus,
1.there is severe airway obstruction
2.no response to the initial standard treatment of asthma
3.severe dyspnea
4.unproductive cough
5.central cyanosis
6.tachycardia
7.sweating
8.pulsus paradoxus (more than 20 mm Hg fall in BP during inspiration)
9.Patient adopts an upright posture fixing the shoulder girdle to assist the accessory muscles of respiration

Treatment:
1.Humidified oxygen (35-60% oxygen)

2.Salbutamol (5 mg) or terbutaline (10 mg) along with Ipratropium bromide 0.5 mg nebulised in oxygen

3.Aminophylline iv can be given if no response is seen

4.Hydrocortisone sodium succinate 100 mg iv, repeat 4-6 hourly in severely ill patients

5.Antibiotics are given if signs of respiratory tract infections are present

6.If no response the above treatment:
endotracheal intubation and mechanical ventilation can be given
Non invasive ventilation with positive pressure ventilation
70-80% helium with oxygen may help

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