External chest compression in acute asthma

Moderately severe anaphylactoid reaction to pentastarch (200/0.5) in a patient with acute severe asthma

“…Ventilation should be initiated at a slow rate (less than 6 min 1 ) with the maximum possible expiratory time, and hand ventilation may be necessary if desaturation occurs with intermittent positive pressure ventilation. If the airway resistance exceeds the elastic recoil of the lungs and chest wall, then expiration will not occur and manual assistance during expiration by squeezing the lateral chest wall at the end of expiration has been reported as life-saving [8].…”

Fortnightly Review: Treatment of acute anaphylaxis

“…Most patients will improve with this treatment. Artificial ventilation should be at a slow rate to allow time for expiration and to prevent overinflation; it can be facilitated by compressing the chest during expiration 22. Refractory bronchospasm, particularly in children, may improve with nebulised and intravenous salbutamol, and with intravenous aminophylline, isoflurane, and ketamine 15…”

The pulmonary physician in critical care * 12: Acute severe asthma in the intensive care unit

“…79 Hyperinflation is relieved by manual compression of the chest wall during expiration. 80 The technique has been advocated and used with success in both intubated and nonintubated patients, although it has not been fully evaluated by a controlled clinical study in humans. 81 80 Mucolytics There is often a striking degree of mucus impaction in both large and small airways that contributes to hyperinflation, segmental and lobar collapse with shunting, increased airway pressure, and barotrauma.…”