An analysis and comparison of 286 adult patients involving 560 episodes of
status asthmaticus admitted to the Medical Service of Chulalongkorn Hospital during the years 1984 through 1988 were examined. There were 58 patients who required
mechanical ventilation 75 times compared with 228 patients with 485 episodes of attack who did not require the use of
mechanical ventilation. The increased risk factors for
status asthmaticus among those who required assisted ventilation were as follows: younger age at onset of
asthma, younger age of severe attack, chronic
asthma (especially unstable
asthma), previous history of intubation and
mechanical ventilation, shorter duration of severe attack and extremely severe attack in the sitting position before arriving at the emergency room, receiving beta 2
adrenergic inhaler, mistakenly taking beta blockers, high
fever (over 38 degrees C) as a result of
respiratory tract infection, increased initial pulse rate (over 125 beats/minute) and white blood cell count of over 16,000/mm3, and
pneumothorax on admission. Simple
asthma and history of taking
franol or
tedral in
status asthmaticus indicated a low risk for
mechanical ventilation. The taking of
glucocorticoids did not pose a risk to
status asthmaticus requiring
mechanical ventilation.