EXPERIENCE OF TREATMENT WITH ACUTE ATTACK OF
SEVERE ASTHMA
Liu Meiqin,
Wei Xijing and Zhao Shujie
Dept. of pediatrics, the 323rd military
hospital, Xi’an, Shanxi, China
We
reported our treatment experience with 69 patients with severe asthma,
which was defined using the criteria of Chinese Journal of Tuberculosis and
Respiratory Disease 1993, 16 (suppl. Asthma). In all patients, 55(M/F
31/24) were children, with ages from 3 months to 12 years, attacked with
moderate or severe asthma. 9 children patients were less than 3 years, and
46 ranged in age from 3 to 12 years. 14 patients (M/F5/9) belonged to
adults asthma. In these children asthma, 10 possessed personal
hypersensitivity history. 16 had family history of sensitivity in their I
or II grade relativity. The induced factors are as follows: post-exercise,
inhaled cold-air, fatigue or attach to allergic agents. All patients had
different degrees of dyspnea or short of breath, frequently coughing,
tightness in the chest, and palpitation, some patients breathed hard and
had to sit up all night or felt dysphoretic, some were anteverted with
their speech difficulty, and mental stress, restless, perspiration.
Participation of assistant respiratory muscles and conflicted motion of
chest and abdomen in some severe patients with short of shallow breathing
may appear. Their heart rates were usually more than 120/min. Pulmonary
function examination showed PEF>30%, PEV1<60% expected value.
Analysis of arterial gas showed various degrees of low-oxygen blood and high-PaCo2.
Experience:
First, it’s necessary for asthmatic patients to individualize the treatment
with medicine. Based on the combination treatment of giving oxygen and
transfusion, relief of bronchial spasm as well as anti-inflammatory was
important, and should be used as regular treatment., thus the symptom of
dysponea and lung function and low-oxygen blood in asthmatic patients can
be improved during acute asthmatic attack. All necessary treatment should
be giving as soon as possible. These measurements involved as follows:(1)
Beta 2 receptor antagonist was inhaled for relieving of bronchial spasm,
usually 0.5%Vetolin solution is the drug of first choice. (2)
Corticosteroids should be given by intravenous drip simultaneously.
(3)Antihistamine and aminophylline were also recommended in dealing with
the severe asthmatic attack.. Regular therapeutic course is 3~6 months
during the period of acute attack. The treatment may in time be given
individually according the different course and patients’ conditions. The
dosage of medicine should be adjusted promptly. Once acute asthmatic attack
was controlled, the time of maintenance therapy and maintenance dosage
should be depended upon the patients’ specific condition. It is worth
noting that the side effects of aminophylline by intravenous administration
in some primary hospitals should be kept close observation. The drug should
be discontinued if its toxicity and side -effects were occurred, and other
therapeutic measures were also resorted. In addition, education of
asthmatic knowledge must be given the patients while in period of
remission.