[Acute severe asthma in children. Epidemiological, physiopathological and clinical aspects].
Therapy for asthma is being prescribed more frequently. However, asthma mortality remains high in many countries. Fatal outcome is not always related to inadequate follow-up. In this article we report that children with mild to moderate symptoms may present a fatal attack. Many factors are responsible for such an outcome: asphyxia +3 due to ventilation/perfusion mismatch and/or bronchospasm, cardiac failure, cardiac arrhythmia, intrinsic positive expiratory pressure, or metabolic disturbances (hypokalemia, for example). Such problems can occur in predisposed patients: it has been shown that the chemosensitivity to hypoxia and the perception of dyspnoea are altered in certain patients with near-fatal asthma. It is very important to identify children at risk of severe asthma and to organize care so as to optimize the management of such children.
Fayon
M
M
Service des soins intensifs pédiatriques, hôpital Pellegrin-Enfants, CHU de Bordeaux, France.
Lamireau
T
T
Sarlangue
J
J
Demarquez
J L
JL
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D003937:Diagnosis, Differential; D006801:Humans