What is a common complication of severe asthma exacerbation?

In the context of a severe asthma exacerbation, the most relevant complication is pneumothorax. This can occur due to the extreme pressures created in the thoracic cavity during severe respiratory distress and the forceful contraction of the respiratory muscles. In some cases, the high intrathoracic pressure associated with intense respiratory effort can cause a rupture of alveoli, leading to a pneumothorax.

Pneumothorax is particularly concerning in patients with asthma because their already compromised airways may further trap air in the pleural space. This additional air can create increased pressure on the lung, impairing ventilation and leading to respiratory failure. Identifying and managing a pneumothorax in the setting of severe asthma is critical, as it can exacerbate hypoxia and respiratory distress.

While other conditions like hypovolemic shock, barotrauma, and dehydration can be serious in their own right, they are not as directly associated with the mechanics of a severe asthma attack compared to pneumothorax. This makes the incidence of pneumothorax a key consideration during the assessment and management of patients experiencing a severe asthma exacerbation.