Asthma persistence

Asthma persistence refers to a severe asthma attack that is ineffective in conventional treatment and generally lasts more than 12 hours. Asthma persistence is not an independent type of asthma, but its pathological and physiological changes are more serious. If its severity is underestimated or treatment is not appropriate, there is often a risk of death. Autopsy data from asthma deaths indicate that the most significant abnormality is excessive lung inflation, which is caused by air retention caused by diffuse airway obstruction. There is a wide range of mucus plugs in the airway. This mucus plug is composed of mucus, exfoliated epithelial cells and inflammatory cells, and sometimes forms a small bronchi and its branched casts. The airway wall is thickened, with a large number of eosinophils infiltration, hypertrophy and hyperplasia of smooth muscle and submucosal glands. The main manifestation of asthma persistence is shortness of breath. Most patients can only spit words, tachycardia, hyperinflated lungs, wheezing, assisted breathing muscle contraction, odd pulses and sweating. Diagnosis of persistent asthma requires exclusion of cardiogenic asthma, COPD, upper airway obstruction or foreign body, and pulmonary embolism. The most objective indicators for measuring the degree of airway obstruction are: PEFR and / or FEV1. The clinical indications suggesting that asthma is critical is that the condition is still worse under adequate medication; dyspnea affects sleep and speech; assists breathing muscle contraction; changes in consciousness; pneumothorax or mediastinal emphysema; pulse rate 120 times / min; respiratory rate 30 times / min; odd pulse 2.4kPa (18mmHg); FEVl0.5L; FVC1L; PEFR120L / min; PO28.66kPa (65mmHg); PCO2 is higher than normal.

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