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Pulmonary Medicine
Volume 2012 (2012), Article ID 829608, 7 pages
http://dx.doi.org/10.1155/2012/829608
Research Article

Near Fatal Asthma: Clinical and Airway Biopsy Characteristics

1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
2Pulmonary Department, General Hospital of Corfu, Los Angeles, CA 90033, Corfu, Greece
3Department of Pathology, University of Southern California, Los Angeles, CA 90033, USA
4Department of Biostatistics, Clinical Trials Unit, University of Southern California, Los Angeles, CA 90033, USA

Received 23 July 2011; Revised 18 October 2011; Accepted 7 November 2011

Academic Editor: Thais Mauad

Copyright © 2012 Richard G. Barbers et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Inflammation and remodeling are integral parts of asthma pathophysiology. We sought to describe the clinical and pathologic features of near fatal asthma exacerbation (NFE). Methods. Bronchial biopsies were collected prospectively from NFE I subjects. Another NFE II group and a moderate severity exacerbation control group (ME II) were retrospectively identified—no biopsies obtained. Results. All NFE II ( 𝑛 = 9 ) subjects exhibited remodeling and significant inflammation (eosinophilic, neutrophilic). NFE II group ( 𝑛 = 3 7 ) had a significant history of prior intubation and inhaled corticosteroids usage compared to ME II group ( 𝑛 = 4 1 ). They also exhibited leukocytosis, eosinophilia, and longer hospitalization days. Conclusions. Remodeling, eosinophilic, and neutrophilic inflammation were observed in NFE. NFE is associated with prior intubation and inhaled corticosteroids usage.