Near-fatal asthma: Recognition and management

Research output: Contribution to journalReview articlepeer-review

74 Scopus citations


PURPOSE OF REVIEW: Near-fatal asthma continues to be a significant problem despite the decline in overall asthma mortality. The purpose of this review is to discuss recent advances in our understanding of the pathophysiology, diagnosis and treatment of near-fatal asthma. RECENT FINDINGS: Two distinctive phenotypes of near-fatal asthma have been identified: one with eosinophilic inflammation associated with a gradual onset and a slow response to therapy and a second phenotype with neutrophilic inflammation that has a rapid onset and rapid response to therapy. Patients who develop sudden-onset near-fatal asthma seem to have massive allergen exposure and emotional distress. In stable condition, near-fatal asthma frequently cannot be distinguished from mild asthma. Diminished perception of dyspnea plays a relevant role in treatment delay, near-fatal events, and death in patients with severe asthma. Reduced compliance with anti-inflammatory therapy and ingestion of medications or drugs (heroin, cocaine) have been associated with fatal or near-fatal asthma. SUMMARY: Near-fatal asthma is a subtype of asthma with unique risk factors and variable presentation that requires early recognition and aggressive intervention.

Original languageEnglish (US)
Pages (from-to)13-23
Number of pages11
JournalCurrent Opinion in Pulmonary Medicine
Issue number1
StatePublished - Jan 2008


  • Asthma
  • Fatal asthma
  • Near-fatal asthma
  • Resistant asthma

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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