Causes and Management of Severe Asthma-Status Asthmaticus

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Asthma is a condition where the lower airways, and specifically the bronchi, narrow due to spasm of the muscles in the bronchial walls (bronchospasm). Swelling of the bronchial walls due to inflammation as well as the accumulation of mucus further narrows the bronchi as a result the movement of air into and out of the lungs is hampered. The reason for this narrowing is that the bronchi are hypersensitive. This simply means that when certain harmless substances (allergens) come in contact with the bronchial walls, it triggers an abnormal immune reaction and the bronchi narrow. This is an allergic type of reaction, hence the term allergic asthma. 

Status asthmaticus is a severe case of asthma and not an entirely separate condition.

Risk Factors

The main cause of asthma is unknown. The risks are:

Genetic predisposition

History of atopy (allergic tendency)

Gastroesophageal reflux disease (GERD)

Air pollution such asdust or cigarette smoke

Viral respiratory illness like the common cold, exposure to cold

Strenuous physical activity including exercise

Use of certain medication such as NSAIDs (example: aspirin) or beta-blockers.

Signs and Symptoms

Incessant and rapid breathing with wheezing

Chronic shortness of breath 

Enlargement of the chest

Loss of concentrating and confused

Bluish tinge of the lips (warning sign)

Using neck and abdominal muscles to breathe

Treatment  

Medication: drugs include beta-agonists, corticosteroids and theophylline

Oxygen administration

Adequate ventilation 

Antibiotics for bacterial infections

Prevention

Continuous use of medication

Avoid triggers

Reduce exposure to air pollutants

Avoid strenuous exercise

Identify and avoid trigger food