Pathophysiology and appropriate management of acute asthma

ABSTRACT

To study pathophysiology and guidelines for the diagnosis and management of acute asthma. Prospective study of management of known cases of acute asthma for a period of 3 months. Department of Chest Medicine, Jinnah Post Graduate Medical Centre, Karachi. 300 cases of known acute asthma were included. Management was initiated with saturated oxygen and Salbutamol nebulizer. Subsequent treatment was added if sign and symptom did not regress. Hydrocortisone [after 15 minutes], Ipratropium [after 30 minutes] and Aminophylline [after 1 hour]. 190/250 [76%] males and 40/50 [80%] females, total 210/300 [70%] patients became stable after initial treatment. 3 0/60 [50%] males and 10/10 [100%] female, total 40/70 [57%] were stable after Hydrocortisone was added. 20/30 [66%] male patient became asymptomatic after treatment with Ipratropium. 10 patients became asymptomatic after 1 hour of treatment with Arninophylline. No adverse effects were observed. Acute asthma is highly variable clinical condition therefore the level of control must be monitored on a periodic basis to determine whether therapy should be maintained or adjusted. It includes symptomatic relief as well as arrest of pathophysiolgical mechanism of asthma