Bronchial asthma in intensive care department: the factors influencing on exacerbation severity

The high frequency of severe exacerbation of bronchial asthma (BA) is still one of the main problems for pulmonologists in Ukraine.

Ninety-eight of 620 asthmatics, surveyed in the diagnostic center 'Pulmis' in Dniepropetrovsk during 10 months of 2000, were referred to the intensive care department because of severe exacerbation of disease.

The aim of present research was to study and to estimate the reasons for patients with BA hospitalizations in the intensive care department.

Ninety-eight patients of intensive care department (63 men, mean age 45.5 ± 3.2 years, mean duration of disease 8.3 ± 1.7 years) with severe BA (according to GINA classification) were enrolled into the study.

We evaluate patients' educational level, their medication and compliance. According to the results of our research, 34 patients (34.7%) did not receive any anti-inflammatory medicine, 17 (17.3%) used only systemic corticosteroids.

Medication of 38 (38.8%) patients consist of short-acting β2-agonists only.

Eighty-three (84.7%) patients have never applied long-acting β2-agonists. Thirteen (13.2%) of them visited 'Asthma-school', 4 (4.1%) patients monitor their peak expiratory flow every day, 12 (12.2%) used additional methods of drug delivery (spasers, etc.).

The results show that inadequate anti-inflammatory and bron-chodilator therapy, low educational level of the patients, absence of compliance have significant importance in the development of BA severe exacerbation.