To the Editor.—
In a study of the use of drugs preceding death from asthma, Speizer et al1 stated that further evidence is required before the effect of the bronchodilator aerosols could be assessed adequately. In their study of 113 patients at postmortem examination, classical gross pathological findings in asthma were observed in 110 (97%). Thick, tenacious mucus plugs were present in the smaller bronchi in 106 (93%).In a later study of the circumstances preceding death from asthma in young people, Fraser et al2 found pathological evidence of asthma in 44 of 52 patients; evidence for excessive use of aerosols was definite in nine patients and probable in two others. From facts such as these, it is evident that many of these patients died of their disease and not from the use of isoproterenol aerosols. Death in most instances was due to asphyxia resulting from bronchial obstruction,
Silverglade A. Management of Asthma in Childhood. JAMA. 1974;230(7):963. doi:10.1001/jama.1974.03240070014011
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