Acute Bronchial Asthma

To compare the degree of bronchial obstruction and the clinical manifestations of asthma, we correlated lung mechanics with subjective complaints and physical findings in 22 patients during acute attacks of bronchospasm, and serially during therapy. Only the sign of retraction of the sternocleidomastoid muscle consistently identified those who had severe impairment of pulmonary function; dyspnea and wheezing did not. Regardless of the initial presentation of the patients, when they became asymptomatic, the overall mechanical function of their lungs ranged between 40 and 50 per cent of predicted normal values. When they were without signs of asthma, lung function was only 60 to 70 per cent of predicted values. These abnormalities appear to result from persistent airflow obstruction residing in peripheral airways that is not sufficient to induce symptoms at rest but compromises pulmonary function and may serve as a base for future recurrent episodes of asthma.