Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Status asthmaticusis a severe and potentially life-threateningasthma attack. More commonly known as acute severe asthma, status asthmaticus occurs whenbronchodilator drugsfail to control an attack. Some cases have been known to cause acollapsed lung,coma, andcardiac arrest.
Status asthmatica is a medical emergency that can affect anyone with mild to severe asthma. It is associated with poor asthma control and is commonly seen in poor people who lack access to consistent asthma care. Hospitalization in an intensive care unit is often required.
This article explains what status asthmatic is, including the causes, symptoms, and treatments. It also describes the signs of a medical emergency.
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Status Asthmaticus Symptoms
Symptoms of status asthmaticus are not unlike those of asthma but are considerably worse.
During anattack, the constriction (narrowing) of the airways leads to a drop in oxygen levels and an increase in carbon dioxide levels in the blood. The imbalance triggersacute respiratory distress syndrome (ARDS).
With ARDs, fluids accumulate inside the tiny air sacs of the lungs (calledalveoli) andsurfactantsthat enable smooth respiration start to break down.
This can lead to potentially devastating symptoms such as:
In emergencies, these symptoms—commonly referred to as critical asthma syndrome—suggest that the person is at anincreased risk of death.
When to Call 911
How Is Status Asthmaticus Different From an Asthma Attack?
Despite advances in emergency treatment, status asthmaticus (SA) remains a serious health concern. Each year, around 3,500 deaths are attributed to asthma in the United States.
Status asthmatics is more than just a “bad” asthma attack. It is one in which prescription inhalers and asthma medications fail to provide control.
Slow-Onset Status Asthmaticus
Slow-onset SA disproportionately affects poor people who lack adequate access to healthcare. Without consistent access to bronchodilators and otherasthma medications, their ability to maintain long-term control is all but compromised.
According to the Centers for Disease Control and Prevention (CDC), the highest rates of asthma complications and hospitalizations are in Black and American Indian/Native American communities. These are the communities with the highest rates of poverty in the United States.
Struggling with asthma control for more than 17 years independently places you at high risk of status asthmaticus.
Signs of Slow-Onset Status AsthmaticusWith slow onset status asthmaticus, a person will typically develop:A decline inpeak expiratory flow (PEF)of 20% or more using yourpeak flow meterThe increased need for arescue inhalerNighttime awakenings due to your asthmaIncreasing shortness of breath despite the consistent use of asthma medicationsUsing one or more canisters of a short-acting inhaler over the past month
Signs of Slow-Onset Status Asthmaticus
With slow onset status asthmaticus, a person will typically develop:A decline inpeak expiratory flow (PEF)of 20% or more using yourpeak flow meterThe increased need for arescue inhalerNighttime awakenings due to your asthmaIncreasing shortness of breath despite the consistent use of asthma medicationsUsing one or more canisters of a short-acting inhaler over the past month
With slow onset status asthmaticus, a person will typically develop:
Sudden-Onset Status Asthmaticus
This type of SA develops swiftly due to a sudden massive exposure to pollen, dust, foods, sulfites, or other allergy-causing substances (allergens). Sudden-onset SA affects highly allergic people who tend to react adversely to even small amounts of an allergen.
Any person with asthma who has a decline of 30% or more in their PEF (particularly if rescue inhalers are not effective) should seek emergency medical care without exception.
What Are the Diagnostic Criteria for Status Asthmaticus?
What Treatment of Choice for Status Asthmaticus?
Status asthmaticus is treated as a medical emergency. Standard treatment protocols in the emergency room include:
Mechanical ventilationis generally considered a treatment of last resort due to the risk of lung trauma and an increased risk of death. Less than 1% of emergency room visits for asthma require mechanical ventilation.
Extracorporeal membrane oxygenation (ECMO)may be used if mechanical ventilation fails. This involves a machine similar to aheart-lung machinewhich removes blood continuously from the body and returns it after oxygen has been added and carbon dioxide has been removed.
Risk of Death From Status Ashtmaticus
Summary
Acute severe asthma, formerly known as status asthmaticus, is a severe asthma attack that does not respond to self-administered prescription asthma drugs. This can lead to severe respiratory distress and possibly death if not treated as a medical emergency.
Status asthmaticus often occurs when asthma is improperly controlled or when a highly allergic person is exposed to massive amounts of pollen, dust, or other allergens.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Agnihorri NT, Saltoun C.Acute severe asthma (status asthmaticus).Allergy Asthma Proc.2019 Nov 1;40(6):406-409. doi:10.2500/aap.2019.40.4258Kenyon N, Zeki AA, Albertson TE, Louie S.Definition of critical asthma syndromes.Clin Rev Allergy Immunol.2015 Feb;48(1):1-6. doi:10.1007/s12016-013-8395-6Centers for Disease Control and Prevention.Asthma.Mauer Y, Taliercio RM.Managing adult asthma: the 2019 GINA guidelines.Cleve Clin J Med. 2020 Aug 31;87(9):569-575. doi:10.3949/ccjm.87a.19136Brenner B, Corbridge T, Kazzi A.Intubation and mechanical ventilation of the asthmatic patient in respiratory failure.J Allergy Clin Immunol.2009;124(2 Suppl):S19-28. doi:10.1016/j.jaci.2009.05.008Di lascio G, Prifti E, Messai E, et al.Extracorporeal membrane oxygenation support for life-threatening acute severe status asthmaticus.Perfusion.2017;32(2):157-63. doi:10.1177/0267659116670481Sado AI, Afazl MS, Kannekanti L, et al.A meta-analysis on predictors of mortality among patients hospitalized for acute exacerbation of asthma.Cureus.2023 Feb;15(2):e35225. doi:10.7759/cureus.35225
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Agnihorri NT, Saltoun C.Acute severe asthma (status asthmaticus).Allergy Asthma Proc.2019 Nov 1;40(6):406-409. doi:10.2500/aap.2019.40.4258Kenyon N, Zeki AA, Albertson TE, Louie S.Definition of critical asthma syndromes.Clin Rev Allergy Immunol.2015 Feb;48(1):1-6. doi:10.1007/s12016-013-8395-6Centers for Disease Control and Prevention.Asthma.Mauer Y, Taliercio RM.Managing adult asthma: the 2019 GINA guidelines.Cleve Clin J Med. 2020 Aug 31;87(9):569-575. doi:10.3949/ccjm.87a.19136Brenner B, Corbridge T, Kazzi A.Intubation and mechanical ventilation of the asthmatic patient in respiratory failure.J Allergy Clin Immunol.2009;124(2 Suppl):S19-28. doi:10.1016/j.jaci.2009.05.008Di lascio G, Prifti E, Messai E, et al.Extracorporeal membrane oxygenation support for life-threatening acute severe status asthmaticus.Perfusion.2017;32(2):157-63. doi:10.1177/0267659116670481Sado AI, Afazl MS, Kannekanti L, et al.A meta-analysis on predictors of mortality among patients hospitalized for acute exacerbation of asthma.Cureus.2023 Feb;15(2):e35225. doi:10.7759/cureus.35225
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Agnihorri NT, Saltoun C.Acute severe asthma (status asthmaticus).Allergy Asthma Proc.2019 Nov 1;40(6):406-409. doi:10.2500/aap.2019.40.4258Kenyon N, Zeki AA, Albertson TE, Louie S.Definition of critical asthma syndromes.Clin Rev Allergy Immunol.2015 Feb;48(1):1-6. doi:10.1007/s12016-013-8395-6Centers for Disease Control and Prevention.Asthma.Mauer Y, Taliercio RM.Managing adult asthma: the 2019 GINA guidelines.Cleve Clin J Med. 2020 Aug 31;87(9):569-575. doi:10.3949/ccjm.87a.19136Brenner B, Corbridge T, Kazzi A.Intubation and mechanical ventilation of the asthmatic patient in respiratory failure.J Allergy Clin Immunol.2009;124(2 Suppl):S19-28. doi:10.1016/j.jaci.2009.05.008Di lascio G, Prifti E, Messai E, et al.Extracorporeal membrane oxygenation support for life-threatening acute severe status asthmaticus.Perfusion.2017;32(2):157-63. doi:10.1177/0267659116670481Sado AI, Afazl MS, Kannekanti L, et al.A meta-analysis on predictors of mortality among patients hospitalized for acute exacerbation of asthma.Cureus.2023 Feb;15(2):e35225. doi:10.7759/cureus.35225
Agnihorri NT, Saltoun C.Acute severe asthma (status asthmaticus).Allergy Asthma Proc.2019 Nov 1;40(6):406-409. doi:10.2500/aap.2019.40.4258
Kenyon N, Zeki AA, Albertson TE, Louie S.Definition of critical asthma syndromes.Clin Rev Allergy Immunol.2015 Feb;48(1):1-6. doi:10.1007/s12016-013-8395-6
Centers for Disease Control and Prevention.Asthma.
Mauer Y, Taliercio RM.Managing adult asthma: the 2019 GINA guidelines.Cleve Clin J Med. 2020 Aug 31;87(9):569-575. doi:10.3949/ccjm.87a.19136
Brenner B, Corbridge T, Kazzi A.Intubation and mechanical ventilation of the asthmatic patient in respiratory failure.J Allergy Clin Immunol.2009;124(2 Suppl):S19-28. doi:10.1016/j.jaci.2009.05.008
Di lascio G, Prifti E, Messai E, et al.Extracorporeal membrane oxygenation support for life-threatening acute severe status asthmaticus.Perfusion.2017;32(2):157-63. doi:10.1177/0267659116670481
Sado AI, Afazl MS, Kannekanti L, et al.A meta-analysis on predictors of mortality among patients hospitalized for acute exacerbation of asthma.Cureus.2023 Feb;15(2):e35225. doi:10.7759/cureus.35225
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