Severe asthma, although difficult to define, includes all cases of difficult/therapy-resistant disease of all age groups and bears the largest part of morbidity and mortality from asthma. Acute, severe asthma, status asthmaticus, is the more or less rapid but severe asthmatic exacerbation that may not respond to the usual medical treatment. The narrowing of airways causes ventilation perfusion ...

BACKGROUND Noninvasive ventilation (NIV) is an emerging modality in the management of patients with acute respiratory failure. However, its role in severe acute asthma is not well defined. OBJECTIVE Evaluate the efficacy of NIV in severe acute asthma. METHODS Patients with severe acute asthma were randomized to receive either standard medical therapy or NIV in addition to medical therapy. T...

INTRODUCTION Patients with severe acute exacerbations of asthma often receive inappropriate antibiotic treatment. We aimed to determine whether serum procalcitonin (PCT) levels can effectively and safely reduce antibiotic exposure in patients experiencing exacerbations of asthma. METHODS In this randomized controlled trial, a total of 216 patients requiring hospitalization for severe acute ex...

Asthma is a prevalent chronic disease of the respiratory system and acute asthma exacerbations are among the most common causes of presentation to the emergency department (ED) and admission to hospital particularly in children. Bronchial airways inflammation is the most prominent pathological feature of asthma. Inhaled corticosteroids (ICS), through their anti-inflammatory effects have been th...

The current guidelines for prophylactic treatment of paediatric asthma culminate in the addition of regular oral corticosteroids after a stepwise increase in treatment. However, there are still a few patients whose asthma is not controlled despite such maximal conventional treatment and these children are often referred to a tertiary paediatric respiratory centre. Childhood asthma has several m...

The response to glucocorticoids (GCs) therapy classifies severe refractory asthma (SRA) and mild asthma, so the glucocorticoid receptors (GCRs) gene expression may be involved in SRA pathogenesis. Thus, it is aimed to compare the expression levels of two GCR isoforms (GCRα and GCRβ) in SRA, mild asthmatics, and healthy controls. Total RNA was isolated from the peripheral blood mononuclear lymph...

The current guidelines for prophylactic treatment of paediatric asthma culminate in the addition of regular oral corticosteroids after a stepwise increase in treatment. However, there are still a few patients whose asthma is not controlled despite such maximal conventional treatment and these children are often referred to a tertiary paediatric respiratory centre. Childhood asthma has several m...

Nebulized salbutamol has been known to be an effective treatment of asthma for almost two decades [1] and nebulized bronchodilator therapy has now become firstline treatment of severe acute asthma in the Emergency Departments of most British hospitals [2]. This treatment was recommended as the most effective in 1972 [3J. but after the advent of intravenous salbutamol and terbutaline the choice ...

BACKGROUND It is hypothesised that, despite recent initiatives to improve asthma self-management including asthma education, detailed investigation of the sequence of events culminating in hospital admission will lead to the identification of important management errors and thus the likelihood that the majority of severe asthma attacks are preventable by currently available strategies, and that...

BACKGROUND Many patients with asthma require frequent rescue medication for acute symptoms despite appropriate controller therapies. Thus, determining the most effective relief regimen is important in the management of more severe asthma. This study's objective was to evaluate whether ipratropium bromide/albuterol metered-dose inhaler (CVT-MDI) provides more effective acute relief of bronchospa...