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Status Asthmaticus - Causes, Symptoms, Diagnosis, and Treatment

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Status asthmaticus occurs due to severe asthma attacks. Read the article below to learn about the symptoms, diagnosis, and treatment of asthmaticus.

Written by

Dr. Saberitha

Medically reviewed by

Dr. Kaushal Bhavsar

Published At November 9, 2022
Reviewed AtNovember 9, 2022


The condition in which the asthmatic condition becomes exacerbated is called status asthmaticus. This medical condition lasts for a few minutes to hours. It is more commonly seen in males than females. The most commonly affected age group is teenage. People living in polluted environments are more likely to get asthma attacks. Also, people in remote rural areas do not have access to health care. Their risk rate is high due to uncontrolled asthma attacks.

What Are the Causes of Status Asthmaticus?

The sources which cause status asthmaticus are as follows;

  • An individual who has an allergy to dust, pollen, toxic gasses, and second-hand smoke gets status asthmaticus.

  • People living near the highways are prone to pollution caused by vehicles. It triggers asthma attacks.

  • Respiratory infections due to constant exposure to the chemicals cause status asthmaticus.

  • People who are living in high altitudes and cold weather face breathing difficulties. It exacerbates asthmatic attacks.

  • The work-related stress or underlying systemic conditions can indirectly result in status asthmaticus.

  • Some individuals are allergic to food items and drugs like sulfites. It worsens asthmatic attacks.

What Are the Symptoms of Status Asthmaticus?

The symptoms of asthmaticus are similar to asthma. They are as follows;

  • Breathing Trouble - The patient affected by asthmaticus gasps for breath. The breath is short and shallow. The patient has difficulty during inspiration and expiration.

  • Wheezing - The triggering agents irritate the lining of the upper respiratory tract and cause wheezing.

  • Coughing - The cough reflex arises to expel the irritants away from the airways.

  • Increased Sweating - The patient with sudden and severe asthma attacks becomes anxious, and there is heavy sweating.

  • Difficulty in Speech - The patient with status asthmaticus struggles to speak during exacerbation.

  • Fatigue - The patient with severe asthma attacks becomes exhausted after physical activity. They appear weak and lose energy due to a lack of oxygen supply.

  • Muscle Pain - Severe exacerbation eventually causes pain in the abdomen, neck, and back muscles.

  • Confusion - The individual who is prone to asthma attacks remains confused most of the time. It is due to the oxygen demand for the brain. It also leads to panic attacks.

  • Discolored Skin - Due to reduced oxygen in the blood, the color of the skin and mucosa present in the lips show a blue tint.

  • Unconscious - The continuous asthma attacks make the patient lose consciousness.

How Is Status Asthmaticus Diagnosed?

The following methods diagnose severe uncontrolled asthma attacks:

  • Chest X-Rays - Lung and the airways are commonly affected due to status asthmaticus. So the condition of these structures is observed using the radiographic image. The X-ray covers all the organs like blood vessels, heart, and lungs present in the chest area. The complication of asthmaticus, like pneumonia, can be detected using X-rays. The severity of asthmatic attacks can also be determined with X-rays.

  • Electrocardiogram - An electrocardiogram is necessary to determine the condition of the heart. Because the patient has an increased heart rate during severe asthmatic attacks, it is monitored using an electrocardiogram. The heart tries to compensate for the oxygen demand due to status asthmaticus. In such conditions electrocardiogram is used to evaluate the heart valves.

  • Lung Function Test - The lung function test evaluates the gaseous exchange between the lungs and blood. It analyses the oxygen and carbon dioxide level. The lung function test is particularly used to measure expired air. It helps to determine the lung damage caused due to severe asthmatic attacks. It is calculated using a peak flow meter. It is also used to identify the source that triggers the status asthmaticus. A lung function test evaluates the total count of breaths taken in a minute. With the help of this test, the medical professional will determine the mode of treatment.

What Are Treatment Methods for Status Asthmaticus?

  • Inhalers - The narrowing of airways is controlled with the help of bronchodilators. The medical professional usually prescribes inhalational bronchodilators. The commonly used drugs to treat status are Albuterol and Levalbuterol. It helps in the opening of the bronchi and improves the breathing process. Ipratropium bromide is also used to treat asthmaticus. Corticosteroids can reduce the inflammation produced by the triggering agents. Fluticasone is a commonly used inhalational steroid. It has relatively fewer side effects than oral drugs.

  • Medications - Montelukast is given through the oral route to control the symptoms of asthmatic attacks. Theophylline oral drug is also helpful in keeping the airways open. Epinephrine shot is given to the patient with an increased risk of allergy. It lowers the risk of asthmatic attacks.

  • Mechanical Ventilation - Artificial oxygen supply is necessary for uncontrolled severe asthmatic attacks. It is delivered to the patient using a facemask. However, it is a transient condition, and ventilators can be used to manage the condition temporarily. It is used for patients with acute exacerbation and respiratory failure. It is used along with the therapeutic management of status asthmaticus.

What Are the Instructions to Follow for Patients With Status Asthmaticus?

  • Do not stop the medications without the knowledge of the medical professional.

  • Individuals who are prone to asthma must protect themselves from triggering sources.

  • The individual must ensure to take an extra inhaler and extra medications to use during an emergency and travel.

  • Annual health checkups and regular monitoring of respiratory symptoms are vital to prevent severe asthmatic attacks.

  • Follow the treatment plan as per the instructions given by the medical professional.


If status asthmaticus is not managed during the early stages of life, it could lead to respiratory failure. To avoid life-threatening conditions like lung collapse and pneumonia, consult a physician. Patients with regular asthma are prone to status asthmaticus, which is difficult to prevent. However, the risk factors can be reduced by taking the necessary measures. The close acquaintance of the patient with the status asthmaticus must be aware of the symptoms. So that the condition is noticed earlier and the patient is taken to the hospital at the right time.

Frequently Asked Questions


What Is the Most Common Reason for Status Asthmaticus?

Status asthmaticus is a severe and potentially fatal type of asthma exacerbation marked by persistent, severe asthma symptoms that do not respond to normal asthma therapies. One of the most frequent triggers of a status asthmaticus is an upper respiratory infection. A person's breathing becomes more difficult as a result of the infection, as it causes their lungs to produce more mucus.


What Is the Most Effective Treatment for Asthma?

Asthma is a complex and specific disorder; thus, the most effective treatment varies from person to person. Combinations of medications are frequently used for asthma in order to manage symptoms and lower the likelihood of flare-ups. The best long-term control drugs are bronchodilators and inhaled corticosteroids.


What Does a Silent Chest Mean in Status Asthmaticus?

A silent chest is a key and alarming indication of acute airway blockage in status asthmaticus. Due to exhaustion and the inability to move air through severely constricted bronchioles, there is no wheezing or coughing, which is known as a silent chest. Silent chest is a serious medical problem that frequently precedes respiratory failure.


What Are the Three Most Important Measures for Treating Status Asthmaticus?

Status asthmaticus management goals are to reverse airway obstruction quickly through aggressive beta2-agonist use and early corticosteroid administration, correct hypoxemia through monitoring and administering oxygen, and avoid or treat complications like pneumothorax.


What Is Bi-level Positive Airway Pressure (BiPAP) For Status Asthmaticus?

Bi-level Positive Airway Pressure (BiPAP) is emerging as a valuable and non-invasive mechanical ventilation approach for children experiencing severe asthma exacerbations who do not respond to conventional treatments and are at risk of respiratory failure. 


What Is the Purpose of IV Fluids in Asthma?

Intravenous magnesium sulfate can effectively treat patients who report to the emergency department following an acute asthma exacerbation. For acute and persistent asthma, intravenous therapy with numerous minerals, including magnesium, may be beneficial.


What Is Another Term for Status Asthmaticus?

Status asthmaticus is also known as "acute severe asthma exacerbation." Both describe a severe and potentially fatal exacerbation of asthma symptoms that does not respond adequately to traditional therapies such as bronchodilators and corticosteroids.


What Is the Ideal Injection for Asthma?

Systemic steroids (steroids given orally or by injection that have an overall effect on the body), including Prednisone, Methylprednisolone, and Prednisolone, are prescribed for the management of severe asthma episodes, allowing people to obtain improved asthma control.


Why Should Intubation Be Avoided in Status Asthmaticus?

In the treatment of status asthmaticus, intubation (insertion of a breathing tube into the airway) is normally avoided if at all possible.  The choice to intubate a patient with status asthmaticus is made clinically.  Bronchospasms can be exacerbated by intubation, making breathing more difficult and inducing laryngospasms.


What Is the Purpose of Epinephrine in Status Asthmaticus?

Epinephrine can be used to treat status asthmaticus. The major goal of epinephrine is to quickly reduce bronchoconstriction (airway narrowing) and enhance the patient's breathing. 


Can Status Asthmaticus Be Reversed?

Individual attacks of asthma can frequently be avoided, but the condition is a chronic one that cannot be treated. Although most asthma symptoms are treatable and reversible, some people with chronic asthma may develop permanent constriction of their airways and other long-term issues.
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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)


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