Abstract
Blood gas measurements obtained during 35 episodes of acute, severe asthma in 19 children were analysed. Arterial carbon dioxide tension (PaCO2) was mean (SD) 5.7 (1.2) kPa and the arterial oxygen tension (PaO2) was 7.7 (1.1)kPa. Hypoxaemia was severe (PaO2 less than or equal to 7.9 kPa) on 19 occasions, was present alone (type I) on eight of these, and was associated with hypercapnia (type II) on 11. The PaO2 was similar in both the type I and type II subgroups, but PaCO2 was significantly higher in the type II and the alveolar-arterial oxygen tension difference was significantly higher in the type I subgroup. Classification of acute respiratory failure into these two types proved useful in understanding the pathophysiology of acute, severe asthma. Type I failure, conventionally regarded as a precursor of type II, itself caused severe, critical hypoxaemia.
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Selected References
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- Balk R., Bone R. C. Classification of acute respiratory failure. Med Clin North Am. 1983 May;67(3):551–556. doi: 10.1016/s0025-7125(16)31188-9. [DOI] [PubMed] [Google Scholar]
- Bhagat R. G., Grunstein M. M. Comparison of responsiveness to methacholine, histamine, and exercise in subgroups of asthmatic children. Am Rev Respir Dis. 1984 Feb;129(2):221–224. [PubMed] [Google Scholar]
- Bradley C. A., Fleetham J. A., Anthonisen N. R. Ventilatory control in patients with hypoxemia due to obstructive lung disease. Am Rev Respir Dis. 1979 Jul;120(1):21–30. doi: 10.1164/arrd.1979.120.1.21. [DOI] [PubMed] [Google Scholar]
- D'Alonzo G. E., Dantzker D. R. Respiratory failure, mechanisms of abnormal gas exchange, and oxygen delivery. Med Clin North Am. 1983 May;67(3):557–571. doi: 10.1016/s0025-7125(16)31189-0. [DOI] [PubMed] [Google Scholar]
- Downes J. J., Wood D. W., Striker T. W., Pittman J. C. Arterial blood gas and acid-base disorders in infants and children with status asthmaticus. Pediatrics. 1968 Aug;42(2):238–249. [PubMed] [Google Scholar]
- Hutchison A. A., Olinsky A. Hypoxic and hypercapnic response in asthmatic subjects with previous respiratory failure. Thorax. 1981 Oct;36(10):759–763. doi: 10.1136/thx.36.10.759. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Martin L. Respiratory failure. Med Clin North Am. 1977 Nov;61(6):1369–1396. doi: 10.1016/s0025-7125(16)31267-6. [DOI] [PubMed] [Google Scholar]
- McFadden E. R., Jr, Lyons H. A. Arterial-blood gas tension in asthma. N Engl J Med. 1968 May 9;278(19):1027–1032. doi: 10.1056/NEJM196805092781901. [DOI] [PubMed] [Google Scholar]
- McKenzie S. A., Edmunds A. T., Godfrey S. Status asthmaticus in children: a one-year study. Arch Dis Child. 1979 Aug;54(8):581–586. doi: 10.1136/adc.54.8.581. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Morrill C. G., Dickey D. W., Cropp G. J. Ventilatory response and drive of asthmatic children to alveolar hypoxia. Pediatr Res. 1981 Dec;15(12):1520–1524. doi: 10.1203/00006450-198112000-00014. [DOI] [PubMed] [Google Scholar]
- Nowak R. M., Tomlanovich M. C., Sarkar D. D., Kvale P. A., Anderson J. A. Arterial blood gases and pulmonary function testing in acute bronchial asthma. Predicting patient outcomes. JAMA. 1983 Apr 15;249(15):2043–2046. [PubMed] [Google Scholar]
- Rebuck A. S., Braude A. C., Chapman K. R. Evaluation of the severity of the acute asthmatic attack. Chest. 1982 Jul;82(1 Suppl):28S–29S. doi: 10.1378/chest.82.1_supplement.28s. [DOI] [PubMed] [Google Scholar]
- Rebuck A. S., Read J. Assessment and management of severe asthma. Am J Med. 1971 Dec;51(6):788–798. doi: 10.1016/0002-9343(71)90307-x. [DOI] [PubMed] [Google Scholar]
- Siggaard-Andersen O. An acid-base chart for arterial blood with normal and pathophysiological reference areas. Scand J Clin Lab Invest. 1971 May;27(3):239–245. doi: 10.3109/00365517109080214. [DOI] [PubMed] [Google Scholar]
- Simpson H., Forfar J. O., Grubb D. J. Arterial blood gas tensions and pH in acute asthma in childhood. Br Med J. 1968 Aug 24;3(5616):460–464. doi: 10.1136/bmj.3.5616.460. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Weiss E. B., Faling L. J. Clinical significance of PaCO2 during status asthma: the cross-over point. Ann Allergy. 1968 Oct;26(10):545–551. [PubMed] [Google Scholar]
