The diagnostic criteria for status asthmaticus are outlined as well as the basic pathophysiology with bronchial obstruction as the main feature, the net effect of which is impairment of ventilatory capacity, uneven ventilation, hyperinflation and arterial hypoxia. The effect on acid-base balance of an asthmatic attack in the earlier stages as well as in a protracted status asthmaticus is discussed. It is emphasized that early and vigorous treatment with bronchodilators, steroids and intravenous fluid administration in most cases prevents the development of respiratory failure with severe acid-base balance disturbances. Oxygen therapy for maintenance of a sufficient oxygen tension is stressed. The use of alkalinizing agents and the aims of assisted ventilation in the children in respiratory failure are discussed.

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