Skip to main content
Thorax logoLink to Thorax
. 1981 Nov;36(11):835–841. doi: 10.1136/thx.36.11.835

Predicting recovery from acute severe asthma.

P F Jenkins, G F Benfield, A P Smith
PMCID: PMC471824  PMID: 7330805

Abstract

Fifty-two patients admitted to hospital with acute severe asthma took part in a prospective study investigating the rate and pattern of their subsequent recovery. Clinical assessment of the severity of the acute attack on admission (according to pulse rate, degree of pulsus paradoxus, and peak expiratory flow rate) did not reliably predict the results of arterial blood gas analysis. Subjects were divided into three groups according to the speed of recovery of peak expiratory flow rate. Historical features associated with slow recovery were: age over 40 years, non-atopic asthma, a longer duration of the acute attack before hospital admission, poor long-term control of asthma, and the use of maintenance oral corticosteroids. The degree of pulsus paradoxus on admission and the improvement in PEFR at six hours and arterial oxygen tension (PaO2) at 48 hours were also useful in predicting speed of recovery. The severity of the attack, assessed on admission by arterial blood gas analysis and PEFR, did not differ between the three groups of recovering patients. Hyperinflation was still present in 15 out of 44 patients investigated five days after admission even though PEFR had returned to mre than 80% of predicted normal in seven of these 15 subjects. The recovery of hypoxia was also commonly delayed with 12 out of 52 patients having PaO2 values of less than 80 mmHg at five days. Persistent hypoxia was more common in those with delayed delayed recovery PEFR.

Full text

PDF
835

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bellamy D., Collins J. V. "Acute" asthma in adults. Thorax. 1979 Feb;34(1):36–39. doi: 10.1136/thx.34.1.36. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cade J. F., Woolcock A. J., Rebuck A. S., Pain M. C. Lung mechanics during provocation of asthma. Clin Sci. 1971 May;40(5):381–391. doi: 10.1042/cs0400381. [DOI] [PubMed] [Google Scholar]
  3. Cayton R. M., Howard P. Plasma cortisol and the use of hydrocortisone in the treatment of status asthmaticus. Thorax. 1973 Sep;28(5):567–573. doi: 10.1136/thx.28.5.567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Fraser P. M., Speizer F. E., Waters S. D., Doll R., Mann N. M. The circumstances preceding death from asthma in young people in 1968 to 1969. Br J Dis Chest. 1971 Apr;65(2):71–84. [PubMed] [Google Scholar]
  5. MacDonald J. B., MacDonald E. T., Seaton A., Williams D. A. Asthma deaths in Cardiff 1963-74: 53 deaths in hospital. Br Med J. 1976 Sep 25;2(6038):721–723. doi: 10.1136/bmj.2.6038.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Macdonald J. B., Seaton A., Williams D. A. Asthma deaths in Cardiff 1963-74: 90 deaths outside hospital. Br Med J. 1976 Jun 19;1(6024):1493–1495. doi: 10.1136/bmj.1.6024.1493. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. McFadden E. R., Jr, Lyons H. A. Serial studies of factors influencing airway dynamics during recovery from acute asthma attacks. J Appl Physiol. 1969 Oct;27(4):452–459. doi: 10.1152/jappl.1969.27.4.452. [DOI] [PubMed] [Google Scholar]
  8. Petheram I. S., Jones D. A., Collins J. V. Patterns of recovery of airflow obstruction in severe acute asthma. Postgrad Med J. 1979 Dec;55 (Suppl 4):877–880. doi: 10.1136/pgmj.55.650.877. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Read J. The reported increase in mortality from asthma: a clinico-functional analysis. Med J Aust. 1968 May 25;1(21):879–884. doi: 10.5694/j.1326-5377.1968.tb28997.x. [DOI] [PubMed] [Google Scholar]
  10. 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]
  11. Rees H. A., Millar J. S., Donald K. W. A study of the clinical course and arterial blood gas tensions of patients in status asthmaticus. Q J Med. 1968 Oct;37(148):541–561. [PubMed] [Google Scholar]
  12. Speizer F. E., Doll R., Heaf P. Observations on recent increase in mortality from asthma. Br Med J. 1968 Feb 10;1(5588):335–339. doi: 10.1136/bmj.1.5588.335. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Speizer F. E., Doll R., Heaf P., Strang L. B. Investigation into use of drugs preceding death from asthma. Br Med J. 1968 Feb 10;1(5588):339–343. doi: 10.1136/bmj.1.5588.339. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Tai E., Read J. Blood-gas tensions in bronchial asthma. Lancet. 1967 Mar 25;1(7491):644–646. doi: 10.1016/s0140-6736(67)92541-x. [DOI] [PubMed] [Google Scholar]
  15. Woolcock A. J., Read J. Lung volumes in exacerbations of asthma. Am J Med. 1966 Aug;41(2):259–273. doi: 10.1016/0002-9343(66)90021-0. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES