Zusammenfassung
Der Asthmatod ist selten und bleibt noch immer in vielen Aspekten unverstanden. Klinisch kann bei tödlichen Erkrankungsexazerbationen zwischen dem langsam über Tage hinweg sich entwickelnden „Crescendotyp“ und dem plötzlichen asphyxierenden Asthma unterschieden werden. Für letztere Form des Asthmatodes weisen klinische, pathologisch-anatomische und pathophysiologische Beobachtungen darauf hin, daß massiver Bronchospasmus eine Schlüsselrolle innehat. Exzessiv gesteigerte bronchiale Reagibilität, reduzierte Chemorezeptorensensitivität auf Hypoxie sowie subjektive Unterperzeption der Luftwegsobstruktion scheinen als begünstigende Faktoren wirksam zu werden. Schlechte psychosoziale Verhältnisse und Adoleszenz sind Risikofaktoren auf seiten des Patienten; mangelhafte Dauertherapie, nicht ausreichend energische Akutversorgung und fehlende Erkennung des Risikopatienten werden auf seiten der Medizin risikosteigernd wirksam.
Summary
Fatal asthma is rare and remains an ill-understood entity. From a clinical perspective, one can distinguish between slowly developing fatal or near fatal exacerbations and sudden asphyxiating asthma. Some clinical, pathologic and pathophysiologic evidence suggests that sudden death from asthma might frequently be the consequence of excessive bronchoconstriction. Exaggerated bronchial hyperresponsiveness, reduced chemoreceptor sensitivity to hypoxia, and underperception of airflow obstruction seem to function as pathophysiologic cofactors. Psychosocial problems and adolescence are special patient-related risk factors, while faulty longterm asthma management, insufficient emergency treatment, and lacking identification of patients at risk seem to be medical shortcomings that facilitate a fatal outcome of bronchial asthma.
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Zach, M. (2000). Der plötzliche Asthmatod des Jugendlichen. In: Kummer, F., Kneußl, M. (eds) Das therapieresistente Asthma. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6335-1_4
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DOI: https://doi.org/10.1007/978-3-7091-6335-1_4
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