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A Case of Brain Death Due to Asthma Exacerbation in a Noncompliant Patient with Refractory Asthma

난치성 및 비순응성 천식 환자에서 뇌사에 이른 천식 발작

  • Park, So-Young (Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yoon, Da-Lim (Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kang, Byoung-Ju (Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Ga-Hee (Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Cho, You-Sook (Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Moon, Hee-Bom (Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Tae-Bum (Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 박소영 (울산대학교 의과대학 서울아산병원 알레르기내과) ;
  • 윤다림 (울산대학교 의과대학 서울아산병원 알레르기내과) ;
  • 강병주 (울산대학교 의과대학 서울아산병원 알레르기내과) ;
  • 김가희 (울산대학교 의과대학 서울아산병원 알레르기내과) ;
  • 조유숙 (울산대학교 의과대학 서울아산병원 알레르기내과) ;
  • 문희범 (울산대학교 의과대학 서울아산병원 알레르기내과) ;
  • 김태범 (울산대학교 의과대학 서울아산병원 알레르기내과)
  • Published : 2012.09.01

Abstract

Although guideline-based asthma therapy has had a positive impact on fatalities due to asthma over the last few decades, some patients refractory to or noncompliant with asthma treatment remain at risk of fatality. A 45-year-old female with refractory asthma and poor compliance and with a frequent history of hospitalization for asthma exacerbations was taken to the emergency room because of cardiorespiratory arrest. Her family reported that she had suffered from an upper respiratory infection followed by severe dyspnea for a few days. The patient developed status asthmaticus, and in spite of intensive cardiopulmonary resuscitation, she was eventually declared brain dead. The patient had not taken medication for asthma regularly for several months before the attack. Refractory and difficult-to-treat asthma should be aggressively monitored to prevent severe asthma exacerbations, which can be fatal, especially in noncompliant patients.

난치성 천식으로 잦은 천식 악화를 경험해 온 환자가 더욱이 순응도까지 좋지 않아 평소 천식 조절제를 잘 사용하지 않는 상황에서 심한 천식 발작 후 심폐 정지 및 뇌사에 이른 안타까운 증례이다. 다시 한 번 환자 교육 및 순응도 개선을 위한 의료진의 더욱 적극적인 개입이 중요하다는 점을 강조하는 바이다.

Keywords

References

  1. Kim DI, Kwon HS, Song WJ, et al. Characteristics of the elderly asthma. Korean J Asthma Allergy Clin Immunol 2008;28:98-104.
  2. Kim CY, Park HW, Ko SK, et al. The financial burden of asthma: a nationwide comprehensive survey conducted in the republic of Korea. Allergy Asthma Immunol Res 2011; 3:34-38. https://doi.org/10.4168/aair.2011.3.1.34
  3. Bateman ED, Hurd SS, Barnes PJ, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 2008;31:143-178. https://doi.org/10.1183/09031936.00138707
  4. Sly RM. Continuing decreases in asthma mortality in the United States. Ann Allergy Asthma Immunol 2004;92:313-318. https://doi.org/10.1016/S1081-1206(10)61568-2
  5. KOSIS, Korean Statistical Information Service. Statistics Korea. [Internet]. Seoul: KOSIS, Korean Statistical Information Service, c2012 [cited 2012 Apr 19]. Available from: http://kosis.kr.
  6. Proceedings of the ATS workshop on refractory asthma: current understanding, recommendations, and unanswered questions: American Thoracic Society. Am J Respir Crit Care Med 2000;162:2341-2351. https://doi.org/10.1164/ajrccm.162.6.ats9-00
  7. Yoo KH, Lee KH, Uh ST, Park YB, Rhee YK, Oh YM. Characteristics of difficult to treat asthma in Korea. Tuberc Respir Dis 2010;69:361-367. https://doi.org/10.4046/trd.2010.69.5.361
  8. Cho YJ. Difficult asthma. Korean J Med 2005;69:466-473.
  9. Heaney LG, Horne R. Non-adherence in difficult asthma: time to take it seriously. Thorax 2012;67:268-270. https://doi.org/10.1136/thoraxjnl-2011-200257
  10. Cho SH, Kim YK, Chang YS, Kim SS, Min KU, Kim YY. Asthma insights and reality in Korea. Korean J Med 2006; 70:69-77.
  11. Ignacio-García JM, Pinto-Tenorio M, Chocrón-Giraldez MJ, et al. Benefits at 3 yrs of an asthma education programme coupled with regular reinforcement. Eur Respir J 2002;20: 1095-1101. https://doi.org/10.1183/09031936.02.00016102
  12. Williams LK, Pladevall M, Xi H, et al. Relationship between adherence to inhaled corticosteroids and poor outcomes among adults with asthma. J Allergy Clin Immunol 2004; 114:1288-1293. https://doi.org/10.1016/j.jaci.2004.09.028

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