status asthmaticus :

  1. 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
  1. 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

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