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Acute Asthma Exacerbation (Symptoms ((Life-threatening symptoms (Silent…
Acute Asthma Exacerbation
Pathophysiology
Exposure to Antigen
Plasma cells produce antigen-specific IgE which binds to mast cells
Cross-linking of IgE and the antigen causes degranulation of mast celss releasing inflammatory mediators histamine, bradykinins, leuktrienes, prostaglandins, platelet-activating factor, and interleukins
T-helper cells activate B lymphocytes and eosinophils
Activation of dendritic cells presents antigen to T-helper cells
The inflammatory mediators cause vasodilation, increased capillary permeability, mucosal edema, smooth muscle contraction, and mucous secretion
If bronchospasm not treated and reverse leads to acute asthma attack or status asthmaticus
Symptoms
Oxygen saturation <90%
Respiratory acidosis
Pulsus paradoxes
Expiratory and inspiratory wheezing
Use of accessory muscles
Life-threatening symptoms
Silent chest
Arterial carbon dioxide of >70
Diagnosis
Search for underlying triggers
Expiratory flow rates using peak flow meter
Arterial blood gas
Rapid assessment
Treatment
Inhaled-beta agonist bronchodialators
Immediate administration of oxygen
Coritcosteroids
Mechanical ventilation with hypercapnia and respiratory acidosis