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
- 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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