Severe Asthmatic Crisis in the Intensive Care Unit: Clinical, Epidemiological and Evolutionary Characteristics.
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Abstract
Introduction: Asthma is a chronic inflammatory disease that causes respiratory exacerbations that can be life threatening. Knowing the characteristics and triggers of patients with severe attacks is essential for proper management.
Methods: This retrospective, observational and descriptive study included patients over 18 years old who were admitted to the Intensive Care Unit of Maciel Hospital (Montevideo, Uruguay) with a diagnosis of severe asthma crisis between June 1, 2016, and May 31, 2023.
Results: 61 patients were included, with a mean age of 47.8 ± 16.5 years. 92% had prior emergency consultations and 55.7% had previously required admission to intensive care. 93,4% were not immunized and 80.3% had no prior pulmonary follow-up. All patients required ventilatory support, 48 (78.7%) invasively and 13 (21.3%) non-invasively. Infections were the main cause of decompensation in 49.3% of cases, with viruses being the most common etiology (63.3%). The main complications were infections (13.1%), followed by hypokalemia (11.5%), cardiorespiratory arrest (8.2%), quadriparesis (4.9%) and pneumothorax (4.9%). The median length of stay was 5 days, with only 1 patient dying (mortality rate of 1.6%). 16.4% required readmission to intensive care within 6 months.
Conclusions: Most patients are young, with few follow-ups during stable phases and low immunization rates. They have high ventilatory support requirements but a short ICU stay and low mortality. Achieving adequate control and treatment adherence during stable phases is essential to prevent severe crises.
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References
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