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Acute Asthma Exacerbation (Clinical Presentation (Hypoxia, tachypnea,…
Acute Asthma Exacerbation
Epidimiology
Acute attacks higher in obese patients, GERD, Allergic rhinnitis
Females at higher risk for hospitalization due to exacerbation
Higher in makes before puberty , then higher in females after puberty
Clinical Presentation
Hypoxia, tachypnea
Inability to catch one's breath
May not be controlled with rescue inhaler
Progressive wheezing, chest tightness, shortness of air
Severe and Sudden Onset with known asthma history
Treatment
Systemic Steroids,Inhaled Bronchodilators,
Supplemental oxygen for hypoxemia
Review and adjustment of medications with follow-up
Intubation/Hospitalization
Risk Factors
Repeated exposure to extrinsic irritants (smoke, fumes, pollen)
Stress, exercise
Obesity, GERD, Allergic Rhinnitis, Viral/Bacterial infections
NSAIDS's, Aspirin, Beta-Blockers
Exacerbation prone phenotype
Pathophysiology
Airway inflammation, can be extrinsic or intrinsic triggered
Dendritic and mast cell production increases, resulting in increased eosinophils
Epithelial shedding and mucous production increase
Intermittent airway obstruction occurs
Smooth muscle remodeling occurs
Can result in long term pulmonary tissue damage
Bronchospasms occur in response
Diagnosis
Peak Flow test, Spirometry
Arterial Blood Gases
Clinical Exam & History