ERJ
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Permissions
Right arrowRequest Permissions
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Rodriguez-Roisin, R
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Rodriguez-Roisin, R
Eur Respir J 1997; 10: 1359-1371
Copyright © ERS Journals Ltd 1997

Original Articles

Acute severe asthma: pathophysiology and pathobiology of gas exchange abnormalities

R Rodriguez-Roisin

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 circulation was antagonized. Taken together, these findings support the hypothesis that platelet-activating factor may play a critical role in the pathobiology of severe acute exacerbations of asthma.


This article has been cited by other articles:


Home page
 J. Appl. Physiol.Home page
P. A. Munoz, F. P. Gomez, H. A. Manrique, J. Roca, J. A. Barbera, I. H. Young, S. D. Anderson, and R. Rodriguez-Roisin
Pulmonary gas exchange response to exercise- and mannitol-induced bronchoconstriction in mild asthma
J Appl Physiol, November 1, 2008; 105(5): 1477 - 1485.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A. Casas, F. P. Gomez, B. Dahlen, J. Roca, J. A. Barbera, S-E. Dahlen, and R. Rodriguez-Roisin
Leukotriene D4-induced hypoxaemia in asthma is mediated by the cys-leukotriene1 receptor
Eur. Respir. J., September 1, 2005; 26(3): 442 - 448.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
G. J. Rodrigo, C. Rodrigo, and J. B. Hall
Acute Asthma in Adults: A Review
Chest, March 1, 2004; 125(3): 1081 - 1102.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
J. Gabrijelcic, A. Casas, R.A. Rabinovich, J. Roca, J.A. Barbera, K.F. Chung, and R. Rodriguez-Roisin
Formoterol protects against platelet-activating factor-induced effects in asthma
Eur. Respir. J., January 1, 2004; 23(1): 71 - 75.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
G. J. Rodrigo, M. R. Verde, V. Peregalli, and C. Rodrigo
Effects of Short-term 28% and 100% Oxygen on PaCO2 and Peak Expiratory Flow Rate in Acute Asthma: A Randomized Trial
Chest, October 1, 2003; 124(4): 1312 - 1317.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A.A. Acuna, J. Gabrijelcic, E.M. Uribe, R. Rabinovich, J. Roca, J.A. Barbera, K.F. Chung, and R. Rodriguez-Roisin
Fluticasone propionate attenuates platelet-activating factor-induced gas exchange defects in mild asthma
Eur. Respir. J., May 1, 2002; 19(5): 872 - 878.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. L. ECHAZARRETA, B. DAHLEN, G. GARCIA, C. AGUSTI, J. A. BARBERA, J. ROCA, S.-E. DAHLEN, and R. RODRIGUEZ-ROISIN
Pulmonary Gas Exchange and Sputum Cellular Responses to Inhaled Leukotriene D4 in Asthma
Am. J. Respir. Crit. Care Med., July 15, 2001; 164(2): 202 - 206.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A.L. Echazarreta, F.P. Gomez, J. Ribas, E. Sala, J.A. Barbera, J. Roca, and R. Rodriguez-Roisin
Pulmonary gas exchange responses to histamine and methacholine challenges in mild asthma
Eur. Respir. J., April 1, 2001; 17(4): 609 - 614.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. SANTOS, M. FERRER, J. ROCA, A. TORRES, C. HERNÁNDEZ, and R. RODRIGUEZ-ROISIN
Pulmonary Gas Exchange Response to Oxygen Breathing in Acute Lung Injury
Am. J. Respir. Crit. Care Med., January 1, 2000; 161(1): 26 - 31.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. P. GÓMEZ, R. IGLESIA, J. ROCA, J. A. BARBERÁ, K. FAN CHUNG, and R. RODRIGUEZ-ROISIN
The Effects of 5-Lipoxygenase Inhibition by Zileuton on Platelet-activating-factor-induced Pulmonary Abnormalities in Mild Asthma
Am. J. Respir. Crit. Care Med., May 1, 1997; 157(5): 1559 - 1564.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1997 by the European Respiratory Society.