[Sudden unexpected death and near death among children with asthma]

Abstract

During four winter months 1989-90, two children died suddenly from asthma, and one suffered a life threatening attack. A 20 months old boy with moderately severe asthma, just recovered from an adenovirus infection, was symptom free at a routine consultation less than 12 hours before death. He died suddenly after a spell of coughing. A six year old girl with severe but well controlled asthma received unknown quantities of inhaled nebulized salbutamol during a three day exacerbation. She died at home due to respiratory arrest. A 16 year old boy who attended the clinic sporadically had a severe uncontrolled attack of asthma. He inhaled at least 400 doses of salbutamol via a metered dose inhaler during the two days prior to a sudden respiratory arrest. He was successfully resuscitated. This paper addresses possible mechanisms underlying different types of severe attacks of asthma.