Potentially (near) fatal asthma.

Abstract:

:Potentially (near) fatal asthma (PFA) defines a subset of patients with asthma who are at increased risk for death from their disease. The diagnosis of PFA should motivate treating physicians, health professionals, and patients to be more aggressive in the monitoring, treatment, and control of this high-risk type of asthma. A diagnosis of PFA is made when any one of the following are present: (1) a history of endotracheal intubation from asthma, (2) acute respiratory acidosis (pH < 7.35) or respiratory failure from acute severe asthma, (3) two or more episodes of acute pneumothorax or pneumomediastinum from asthma, (4) two or more episodes of acute severe asthma, despite the use of long-term oral corticosteroids and other antiasthma medications. There are two predominant phenotypes of near-fatal exacerbations: "subacute" exacerbation and "hyperacute" exacerbation. The best way to "treat" acute severe asthma is 3-7 days before it occurs (i.e., at the onset of symptoms or change in respiratory function) and to optimize control of asthma by decreasing the number of symptomatic days and the days and/or nights that require rescue therapy and increasing baseline respiratory status in "poor perceivers." PFA is treated with a multifaceted approach; physicians and health-care professionals should appreciate limitations of pharmacotherapy, including combination inhaled corticosteroid-long-acting β-agonist products as well as addressing nonadherence, psychiatric, and socioeconomic issues that complicate care.

journal_name

Allergy Asthma Proc

authors

Greenberger PA

doi

10.2500/aap.2019.40.4257

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

403-405

issue

6

eissn

1088-5412

issn

1539-6304

journal_volume

40

pub_type

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