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Complications of Severe Asthma.

Complications of Severe Asthma

Asthma can be very complicated and can be associated with some very serious risks. A risk that can be associated with severe asthma is acute severe asthma which you may know by it’s former name “Status Asthmatics “which is severe asthma that is unresponsive to repeated courses of beta-agonist such as inhaled albuterol, levalbuterol or subcutaneous epinephrine.”1 It is a medical emergency that requires prompt treatment. I like to think of this as what concerns most asthmatics, but unfortunately is an ongoing reality for a specific population of asthmatics.

Upper Respiratory Infections – URI’s

Almost 50% of acute severe asthma episodes are related to upper respiratory infections (URIs). Other causes may include medical non-adherence, allergen exposure, irritant inhalation and insufficient use of inhaled and oral corticosteroids. It is mind boggling in me to think that 50% of these episodes are related to URIs. WOW! Even more proof to keep an eye on URIs. Don’t be alarmed. With good control, use of your asthma action plan, and early intervention, these situations can be preventively managed in most cases.

Initial assessments of acute severe asthma include patient history that will specifically look for preventative medication use, history of hospitalization and, emergency room visits, ICU admissions and intubations, frequency of nighttime symptoms, allergens and other medical conditions.1 Physicians will do a series of tests that may include peak flows, spirometry, pulse oximetry, looking for C02 retention.

Impact of upper respiratory failure on severe asthma

An important consideration is the role of respiratory failure in acute severe asthma. It may be potentially reversed however, it is a potentially life-threatening condition.2 There are a number of approaches and it is important to note that individual responses will differ and only your care team can make these decisions with you. One approach that may be discussed is the use of mechanical ventilation, clinicians will be on the lookout for a few signs that this may be necessary which may include deteriorating status, an increase in C02 levels, exhaustion, decreased mental status, hypoxemia instability, and refractory hypoxemia.3 These are never easy decisions for clinicians or easy for families. It is important to get prompt treatment if you feel your asthma is declining. In many cases early intervention greatly improves outcomes and need for escalated treatment.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Authors: Shah, RachnaSaltoun, Carol A. Allergy and Asthma Proceedings, Volume 33, Supplement 1, May/June 2012, pp. S47-S50(4)
  2.  Stather DR, Stewart TE. Clinical review: Mechanical ventilation in severe asthma. Critical Care. 2005;9(6):581-587. doi:10.1186/cc3733.
  3.  National Heart, Lung and Blood Institute . Guidelines for the Diagnosis and Management of Asthma, Expert Panel Report 2. Publication number 97-4051. Bethesda: National Institutes of Health; 1997.


  • Muffle
    4 months ago

    I seem to be getting worse daily…need more medication as if nothing really helps anymore. It might be the chemicals in the medication are making my asthma worse! The pulmonary doctor only said to take more medicine. It seems life is now hopeless for I cannot work many hours and am exhausted if I go outdoors as the air seems polluted.

  • Leon Lebowitz, RRT moderator
    4 months ago

    Hi Muffle, and thanks for your post. Sorry to hear you’re facing such challenges and your condition is worsening on a daily basis. Do you think your physician is treating you properly? That you are on the proper medication regimen for your specific condition? Would you want to seek out another physician who may be able to gain more control with you over the symptoms you have? Leon (site moderator)

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