PMID: 9192945Jun 1, 1997Paper

Acute severe asthma: pathophysiology and pathobiology of gas exchange abnormalities

The European Respiratory Journal
R Rodriguez-Roisin

Abstract

Acute severe asthma, or "status asthmaticus", is a devastating clinical condition ultimately resulting in life-threatening hypoxaemia. The pivotal intrapulmonary mechanism of this condition is profound ventilation/perfusion (V'A/Q') mismatch, characterized by a predominant bimodal blood flow pattern reflecting a marked deterioration (increase) of the dispersion of pulmonary blood flow. This V'A/Q' profile is consistent with the presence of numerous alveolar units with low V'A/Q' ratios, in which ventilation is markedly reduced, although never abolished, but perfusion is maintained. Further V'A/Q' worsening whilst breathing 100% O2 suggests the presence of an underlying vigorous hypoxic vascular response. Of equal importance, gas exchange disturbances are poorly related to the severity of reduced maximal airflow rates. Inhaled platelet-activating factor (PAF), both in normal individuals and asthmatic patients, results in moderate-to-severe disturbance of V'A/Q' status, a finding that is probably related to altered microvascular permeability within the airway wall. Salbutamol, but not ipratropium bromide, prevented all PAF-induced systemic and lung function abnormalities, possibly because venoconstriction in the bronchial circula...Continue Reading

Citations

Mar 30, 2012·European Journal of Clinical Pharmacology·Barbro DahlénRobert Rodriguez-Roisin
May 17, 2011·Clinical Reviews in Allergy & Immunology·Samuel LouieMark Avdalovic
Oct 22, 2011·World Journal of Pediatrics : WJP·Xiao-Fang Wang, Jian-Guo Hong
Oct 13, 2011·Seminars in Respiratory and Critical Care Medicine·Rob Mac SweeneyMichael A Matthay
Jun 12, 2003·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·D Bohn, N Kissoon
Nov 29, 2007·Current Opinion in Pulmonary Medicine·Ruben D Restrepo, Jay Peters
May 29, 1998·American Journal of Respiratory and Critical Care Medicine·F P GómezR Rodriguez-Roisin
Jan 5, 2000·American Journal of Respiratory and Critical Care Medicine·C SantosR Rodriguez-Roisin
Jul 21, 2001·American Journal of Respiratory and Critical Care Medicine·A L EchazarretaR Rodriguez-Roisin
Sep 8, 2009·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Knut Øymar, Thomas Halvorsen
Nov 24, 2007·BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy·F P Gomez, R Rodriguez-Roisin
Nov 17, 2009·Drugs·Spyros A PapirisIraklis Tsangaris
Aug 21, 2013·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Guillermo A RaimondiHoracio J Adrogué
Jun 20, 2014·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Troels JohansenRonald Dahl
May 8, 2015·Lung India : Official Organ of Indian Chest Society·Ritesh AgarwalSubhash Varma
Mar 10, 2004·Chest·Gustavo J RodrigoJesse B Hall
Aug 13, 2003·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·W J LieA T J Tool
Jan 14, 2004·Archivos de bronconeumología·G J RodrigoL J Nannini
Feb 24, 2001·Respiratory Medicine·T K LimA M Stebbings
Apr 13, 2005·Respiratory Medicine·Andrés L EchazarretaRobert Rodríguez-Roisin
Jan 21, 2010·Journal of Intensive Care Medicine·Praveen Mannam, Mark D Siegel
Mar 28, 1998·Thorax·K F Chung
Aug 30, 2008·Journal of Applied Physiology·Phillip A MuñozRoberto Rodríguez-Roisin
Aug 25, 2019·Journal of Clinical Medicine·Eirini KostakouNikoletta Rovina
May 28, 2020·Expert Opinion on Pharmacotherapy·Alessandro VatrellaCarolina Vitale
Feb 11, 2021·American Journal of Physiology. Lung Cellular and Molecular Physiology·Atish GhewareBhavana Prasher

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