Review of acute severe asthma.

Status asthmaticus in the 1980s is still occasionally a fatal disorder. Preventable causes appear to be common: failing to appreciate the severity of the illness and undertreatment, particularly with steroids. Thus, an objective data base, early treatment, and frequent reassessment are of paramount importance. Despite intensive therapeutic intervention, mechanical ventilation may be required. In managing the ventilator in these patients, efforts should be directed at minimizing peak airway pressures while vigorous conventional modalities are continued. The need to use mechanical ventilation does not imply that the course of the disease will worsen, and the long-term outlook generally is good. Thus, even a low mortality rate is troubling. Once the acute process has resolved, educating the patient and close follow-up are essential.