Status asthmaticus

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Classification according to ICD-10
J46 Status asthmaticus
Acute severe bronchial asthma
ICD-10 online (WHO version 2019)

Status asthmaticus is the persistent severe symptoms of an asthma attack over a period of 24 hours. The usual therapeutic measures for asthma are only effective to a limited extent. It is caused by a strong bronchial spasm. The status asthmaticus is a life-threatening condition.

Symptoms of status asthmaticus are dyspnea with panting, accelerated breathing and weakening of the breath sounds due to the narrowing of the bronchi. The insufficient supply of oxygen to the body ( hypoxia ) leads to paleness, blue discoloration ( cyanosis ) of the lips, fingers and toes and impaired consciousness. As the body tries to compensate for the hypoxia, the heart rate increases; this can lead to arrhythmias . Other symptoms are restlessness, pupil size and incontinence.

The most important diagnostic criterion, in addition to the symptoms, is the arterial blood gas analysis , which provides information about the amount of oxygen contained in the blood and thus about the severity.

The status asthmaticus is treated by administering oxygen, with beta-2 sympathomimetics to widen the bronchi, aminophylline and theophylline to relieve bronchospasm, corticosteroids to inhibit the inflammatory reaction and parasympatholytics to inhibit the contraction of the smooth muscles and the production of mucus. In particularly severe cases, non-invasive ventilation or, alternatively, endotracheal intubation and subsequent mechanical ventilation may be necessary.

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