Key messages

• The onset of an asthma attack may be progressive over days or very sudden and unexpected, leading to respiratory arrest within minutes or a few hours (sudden asphyxic asthma). Bronchial obstruction results from mucosal inflammation, muscle spasm, and lumen occlusion by thick mucus.

• Sudden asphyxic asthma may have a distinct pathogenic mechanism and be attributable essentially to a bronchospasm.

• Expiratory air flow rate is reduced due to a decreased lung elastic recoil force, persistent contraction of inspiratory muscles, airways obstruction, and possible glottic aperture.

• Expiration time is so prolonged that inspiration begins before complete air exhalation, leading to progressive hyperinflation and positive end-expiratory pressure (auto-PEEP).

• Bronchial obstruction is associated with increased total lung capacity, functional residual capacity, and residual volume, and with decreased tidal volume and vital capacity.

• Deep negative intrapleural pressures developed during inspiration interfere with cardiovascular function; right ventricle preload and afterload are increased, left ventricle preload is depressed, and afterload is augmented. These alterations account for the development of pulsus paradoxus.

Sleep Apnea

Sleep Apnea

Have You Been Told Over And Over Again That You Snore A Lot, But You Choose To Ignore It? Have you been experiencing lack of sleep at night and find yourself waking up in the wee hours of the morning to find yourself gasping for air?

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