Abstract
Abstract Background and Methods. The majority of asthma-related deaths occur outside the hospital, and therefore the exact factors leading to the terminal event are difficult to ascertain. To examine the mechanisms by which patients might die during acute exacerbations of asthma, we studied 10 such patients who arrived at the hospital in respiratory arrest or in whom it developed soon (within 20 minutes) after admission. Results. The characteristics of the group were similar to those associated in the literature with a high risk of death from asthma, including a long history of the disease in young to middle-aged patients, previous life-threatening attacks or hospitalizations, delay in obtaining medical aid, and sudden onset of a rapidly progressive crisis. Extreme hypercapnia (mean [±SD] partial pressure of arterial carbon dioxide, 97.1 ±31.1 mm Hg) and acidosis (mean [±SD] pH, 7.01±0.11) were found before mechanical ventilation was begun, and four patients had hypokalemia on admission. Despite the sever...
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