난치성 및 비순응성 천식 환자에서 뇌사에 이른 천식 발작
A Case of Brain Death Due to Asthma Exacerbation in a Noncompliant Patient with Refractory Asthma
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초록
난치성 천식으로 잦은 천식 악화를 경험해 온 환자가 더욱이 순응도까지 좋지 않아 평소 천식 조절제를 잘 사용하지 않는 상황에서 심한 천식 발작 후 심폐 정지 및 뇌사에 이른 안타까운 증례이다. 다시 한 번 환자 교육 및 순응도 개선을 위한 의료진의 더욱 적극적인 개입이 중요하다는 점을 강조하는 바이다.
Abstract
Although guideline-based asthma therapy has had a positive impact on fatalities due to asthma over the last few decades, some patients refractory to or noncompliant with asthma treatment remain at risk of fatality. A 45-year-old female with refractory asthma and poor compliance and with a frequent history of hospitalization for asthma exacerbations was taken to the emergency room because of cardiorespiratory arrest. Her family reported that she had suffered from an upper respiratory infection followed by severe dyspnea for a few days. The patient developed status asthmaticus, and in spite of intensive cardiopulmonary resuscitation, she was eventually declared brain dead. The patient had not taken medication for asthma regularly for several months before the attack. Refractory and difficult-to-treat asthma should be aggressively monitored to prevent severe asthma exacerbations, which can be fatal, especially in noncompliant patients. (Korean J Med 2012;83:411-415)
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