Asthmatic status
Asthmatic status is a complication of bronchial asthma, in which there is no sensitivity to drugs used to relieve bouts of the disease. Pathology is characterized by the progression of bronchial obstruction, as well as significant respiratory disorders (up to a coma). The basis of the disease are spasms of the bronchi, swelling of the mucous membrane of the bronchus, as well as viscous sputum in the bronchi, covering its lumen.
Causes
The main reason for the development of asthmatic status is the lack of adequate (basic) therapy of bronchial asthma. The condition develops in cases where the patient refuses to take basic drugs (in particular, the rejection of the use of inhaled glucocoricoids). The disease can develop with uncontrolled intake of beta-2 agonists. You can use such drugs no more than 6-8 times a day. Asthmatic status can develop when excessive exposure to allergens on the body, as well as when taking certain medications that can cause asthma attacks. A contributing factor in the development of asthmatic status is a strong emotional overstrain or the addition of an acute inflammatory process.
Symptoms of asthmatic status
In the first stage of the disease, the patient is not sensitive to beta-2 agonists. The patient has no ventilation disorders. This stage is characterized by anxiety, fear, increasing suffocation, significant difficulties in breathing. The patient is worried about a long unproductive cough, wheezing in the chest, blue lips. In the process of breathing, additional muscles are involved. In the second stage of the disease, there is a sharp aggravation of the symptoms of the first stage. The patient is slowed down, the chest is inflated, there is a drop in supraclavicular and subclavian fossae. There is blueing of the lips, fingertips and other parts of the body. Pulse in a patient is frequent, but weak. Due to the blockage of the bronchi in the body increases the carbon dioxide content. At the third stage there is a sharp violation of the patency of the bronchi. This is the stage of hypercapnic coma. The patient has seizures, coma develops. Patient breathing is rare or absent. There is a sharp drop in blood pressure and a sharp decrease in the oxygen content in the blood.
Diagnostics
At the first stage, the doctor examines the patient for the presence of characteristic symptoms of asthmatic status. Often this is enough to establish a diagnosis. Laboratory diagnosis shows a change in blood gas composition. During peak fluometry, there is a sharp decrease in the volume of inhaled air.
Types of disease
The following forms of asthmatic status are distinguished: · Anaphylactic. It is characterized by a sudden and rapid increase in symptoms of the disease. The development of severe respiratory failure and complete cessation of respiration is possible. The main cause of anaphylactic asthma status is bronchial spasm. Most often develops in response to taking certain medications. In clinical practice, this form of the disease is extremely rare. · Allergic and metabolic. This form of asthmatic status develops very slowly (over several days or weeks). It usually occurs as a complication of asthma. Resistance (lack of sensitivity) to drugs that are used to relieve seizures develops.
Patient’s actions
In order to prevent the development of asthmatic status, it is necessary to adequately treat asthma. With the development of asthmatic status, the patient needs immediate medical attention.
Treatment of asthmatic status
The main drugs in the treatment of asthmatic status are glucocorticoids. These medicines improve the patency of the bronchi, eliminate spasm and swelling. Glucocorticoids can be administered intravenously or orally. In addition to glucocorticoids, short-acting methylxanthines are also used. To compensate for the loss of fluid, glucose solutions and plasma substituting solutions are used. To improve the rheological properties of blood, anticoagulants are used. At the 2 nd and 3 rd stage of the disease artificial lung ventilation can be used. For the prevention of the accession of infectious diseases, antibiotic therapy is carried out. After elimination of asthmatic status, basic therapy of asthma is indicated.
Complications
Complications of asthmatic status can be: · coma; · Development of secondary infection; · Fatal (if untimely provision of medical care). Prevention of asthmatic status
Prevention of asthmatic status is reduced to the timely and adequate treatment of bronchial asthma. Avoid contact with allergens and other factors that contribute to the development of an attack of bronchial asthma.