Status asthmaticus medical therapy: Difference between revisions
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Esther Lee (talk | contribs) Created page with "__NOTOC__ {{Status asthmaticus}} {{CMG}} ==Overview== ==Medical Therapy== ===Therapy based on the stage of the disease diagnosed by Arterial Blood Gas Analysis=== ====Sta..." |
Esther Lee (talk | contribs) |
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==Overview== | ==Overview== | ||
==Medical Therapy== | ==Medical Therapy== | ||
===Therapy based on the | ===Therapy based on the severity of the disease assessed by [[Arterial Blood Gas Analysis]]=== | ||
====Stage 1==== | ====Stage 1==== | ||
*[[Hyperventilation]] with normal PO<sub>2</sub> | *[[Hyperventilation]] with normal PO<sub>2</sub> | ||
| Line 23: | Line 23: | ||
*Severe [[hypoxia]] with markedly elevated PCO<sub>2</sub> | *Severe [[hypoxia]] with markedly elevated PCO<sub>2</sub> | ||
*[[FEV1]] lower than 20% predicted is suggestive of an impending [[respiratory failure|respiratory arrest]] that may require [[intubation]] and [[mechanical ventilation]] | *[[FEV1]] lower than 20% predicted is suggestive of an impending [[respiratory failure|respiratory arrest]] that may require [[intubation]] and [[mechanical ventilation]] | ||
*Metered-dose inhalation of [[Bronchodilator|β2-agonist]] and [[Bronchodilator#Anticholinergics|anticholinergics]] are recommended. Administration of parenteral [[steroids]] and/or [[Bronchodilator#Theophylline|theophylline]] has also shown to be beneficial. | *Metered-dose inhalation of [[Bronchodilator|β2-agonist]] and [[Bronchodilator#Anticholinergics|anticholinergics]] are recommended. Administration of parenteral [[steroids]] and/or [[Bronchodilator#Theophylline|theophylline]] has also shown to be beneficial. | ||
==References== | ==References== | ||
Revision as of 16:21, 25 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
Therapy based on the severity of the disease assessed by Arterial Blood Gas Analysis
Stage 1
- Hyperventilation with normal PO2
- No hypoxemia
- Patients may benefit from nebulized ipratropium used adjunctive to β2-agonist therapy
Stage 2
- Hyperventilation with hypoxemia (low PO2 and PCO2)
- Patients may require corticosteroids in addition to bronchodilator therapy
Stage 3
- CO2 retention due to respiratory muscle fatigue
- Markedly elevated PCO2 levels are an indicator for mechanical ventilation
- Aggressive β2-agonist therapy along with parenteral steroids and/or theophylline is indicated
Stage 4
- Severe hypoxia with markedly elevated PCO2
- FEV1 lower than 20% predicted is suggestive of an impending respiratory arrest that may require intubation and mechanical ventilation
- Metered-dose inhalation of β2-agonist and anticholinergics are recommended. Administration of parenteral steroids and/or theophylline has also shown to be beneficial.