1987 Volume 36 Issue 4 Pages 190-196
Fluid replacement has been considered crucial for the management of status asthmaticus, although there have been few reports of increased ADH during asthmatic attacks, and very few cases of asthmatic attacks accompained by the syndrome of inappropriate secretion of ADH (SIADH) have been reported. ADH appears to play an important role in fluid homeostasis during asthmatic attacks. We have extensively studied ADH using highly sensitive radioimmunoassay as well as serum osmotic pressure, serum Na, BUN and creatinine in asthmatic children with different severity of attachs. ADH of normal controls (17 cases) was 2.38 ± 0.94 pg/ml and that of asthmatic children without attacks (11 cases) was not significantly different (2.34 ± 1.17) from the normal adult controls. Children with mild attacks (22 cases) disclosed slightly increased ADH (4.22 ± 2.17, p<0.01) and those with moderate attacks (13 cases) also showed similar results (4.01 ± 1.96, p<0.01). Markely increased ADH (7.85 ± 3.23) was noted in children with severe attacks (13 cases). However, serum osmolarity, serum Na, BUN and creatinine in all the patients we studied showed no significant differences despite the differences in the severity of attachs. Incleased ADH rapidly returned to the normal range after fluid replacement in only 3 cases out of 9. In conclusion, we should take account of the role of increased ADH in fluid management during asthmatic attacks.
