Mad-about-pediatriccardiology

status asthmaticus : severe asthma unresponsive to  inhaled beta 2 agonists oral or intra venous steroids oxygen bronchospasms, airway constriction, M3 receptors stimulation , tachykinin secretion ---> leads to expiration becoming an active process End expiratory volume increases  Diaphragmmatic flattening from hyperinflation causes additional mechanical disadvantages FEV and FVC are decreased, FRC is increased. pulsus paradoxus : fall in SBP with inspiration - neg intrathoracic pressure, ideally the BP should fall.  leukocytosis ---> infection/ demargination hypokalemia ---> to be expected given continuous beta agonists hypomagnesemia : should be corrected --> has better prognosis all children with first time wheezing and severe status asthmaticus require a chest x ray inhaled beta agonists may nullify the compensatory pulmonary vasocontstriction response and worsen arterial hypoxemia, so O2 must be a part of all asthma treatment