Hypophosphatemia Complicating Bronchodilator Therapy for Acute Severe Asthma

Brady, Hugh R.; Ryan, Francis; Cunningham, John M.; Tormey, William; Ryan, Michael P.; O’Neill, Shane

doi:10.1001/archinte.1989.00390100159034

Cited by 22 publications

(6 citation statements)

References 9 publications

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“…As previously reported in ASA [20], mild hypophosphatemia was found in many of our patients during treatment. Hypophosphatemia seemed to precede hyperlactatemia in most of our patients and the peak arterial lactate level showed a negative correlation with the phosphorus level on admission.…”

Section: Discussionsupporting

confidence: 87%

Hyperlactatemia during acute severe asthma

et al. 1998

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Section: Discussionsupporting

confidence: 87%

Hyperlactatemia during acute severe asthma

et al. 1998

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“…In previous studies, the cause of hypomagnesemia in patients with acute asthma was related to the use of β 2 -agonists either orally or intravenously, or by nebulization, rather than by inhalation [13][14][15]. In addition, oral or intravenous treatment can increase the costs [16,17].…”

Section: Discussionmentioning

confidence: 99%

“…Hypophosphatemia causes impaired respiratory muscle performance, and may worsen respiratory failure in severely ill acute asthmatic patients [12]. Previous studies showed that hypophosphatemia was observed in patients with acute asthma under treatment with nebulized β 2 -agonist, intravenous aminophylline, and corticosteroids [15,18]. Hypophosphatemia may cause clinical deterioration in asthmatic patients due to respiratory muscle fatigue and myocardial depression.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Hypomagnesemia and Pulmonary Function Tests in Patients with Chronic Asthma

et al. 2018

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Objective: To investigate the relationship between serum values of magnesium and the parameters of the pulmonary function tests (PFT) in patients with chronic asthma. Subjects and Methods: This study recruited 50 patients with chronic stable asthma and 40 healthy individuals as a control group. Data on age, sex, severity of asthma, PFT, and details of drug therapy were obtained from each group. Serum magnesium, potassium, phosphorus, calcium, and sodium levels were also measured. To evaluate differences between groups, the Student t test or Mann-Whitney U test was performed for continuous variables, and the χ² test for categorical variables. Results: In the asthma group, 10% (n = 9) of the patients had hypomagnesemia and 5.5% (n = 5) had hypophosphatemia. Patients with asthma were divided into two groups: the hypomagnesemic group (n = 9) and the normomagnesemic group (n = 41). Forced expiratory volume in 1 s (FEV₁), FEV₁%, peak expiratory flow (PEF), and PEF% were lower in the hypomagnesemic group than in the normomagnesemic group (p = 0.02). Multiple logistic regression analysis revealed a statistically significant association between hypomagnesemia and PFT in the hypomagnesemic asthmatic group. The correlations of age with FEV₁, FEV₁%, PEF, and PEF% were as follows: p = 0.00, r = 0.29; p = 0.00, r = 0.43; p = 0.03, r = 0.22; p = 0.00, r = 0.38; and p = 0.03, r = 0.22, respectively. The correlation of serum magnesium levels with PFT (FEV₁, FEV₁%, PEF, PEF%) were as follows: p = 0.001, r = 0.29; p = 0.001, r = 0.43; p = 0.03, r = 0.22; and p = 0.001, r = 0.38, respectively. The other electrolytes were within the normal range in both groups. Conclusion: In this study, hypomagnesemia and hypophosphatemia were found to be the most common electrolyte abnormalities in patients with chronic stable asthma. FEV₁, FEV₁%, PEF, and PEF% were significantly lower in asthmatic patients with hypomagnesemia compared to asthmatic patients with normomagnesemia.

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“…In this study, hypophosphatemia preceded the increase in lactate levels in most patients. Hypophosphatemia may complicate treatment with bronchodilators in acute severe asthma patients [61]. Low phosphate levels in the blood may lead to reduced ATP synthesis in the muscles, accounting for muscle weakness and respiratory and heart failure [62].…”

Section: Metabolic Acidosismentioning

confidence: 99%

Acid-Base Disturbances in Patients with Asthma: A Literature Review and Comments on Their Pathophysiology

Vasileiadis

Alevrakis

Ampelioti

et al. 2019

JCM

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Asthma is a common illness throughout the world that affects the respiratory system function, i.e., a system whose operational adequacy determines the respiratory gases exchange. It is therefore expected that acute severe asthma will be associated with respiratory acid-base disorders. In addition, the resulting hypoxemia along with the circulatory compromise due to heart–lung interactions can reduce tissue oxygenation, with a particular impact on respiratory muscles that have increased energy needs due to the increased workload. Thus, anaerobic metabolism may ensue, leading to lactic acidosis. Additionally, chronic hypocapnia in asthma can cause a compensatory drop in plasma bicarbonate concentration, resulting in non-anion gap acidosis. Indeed, studies have shown that in acute severe asthma, metabolic acid-base disorders may occur, i.e., high anion gap or non-anion gap metabolic acidosis. This review briefly presents studies that have investigated acid-base disorders in asthma, with comments on their underlying pathophysiology.

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Hypophosphatemia Complicating Bronchodilator Therapy for Acute Severe Asthma

Cited by 22 publications

References 9 publications

Hyperlactatemia during acute severe asthma

Hyperlactatemia during acute severe asthma

The Relationship between Hypomagnesemia and Pulmonary Function Tests in Patients with Chronic Asthma

Acid-Base Disturbances in Patients with Asthma: A Literature Review and Comments on Their Pathophysiology

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