Extracorporeal Membrane Oxygenator Support in a Case of Severe Status Asthmaticus

MacDonnell, Kenneth F.; Moon, Hyung S.; Sekar, T.; Ahluwalia, Mohinder P.

doi:10.1016/s0003-4975(10)61538-x

Cited by 41 publications

(20 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Extracorporeal carbon dioxide removal (ECCO 2 R) as an adjunct to the ventilator for refractory asthma was first reported in 1981. 4 Subsequently, there have been several reports on the use of ECCO 2 R to treat this condition. [5][6][7][8] However, prior reports have not captured the spectrum of exacerbation phenotypes in the setting of modern extracorporeal technology.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal carbon dioxide removal for refractory status asthmaticus: experience in distinct exacerbation phenotypes

et al. 2013

View full text Add to dashboard Cite

Extracorporeal carbon dioxide removal (ECCO2R) may be indicated for refractory status asthmaticus when severe dynamic hyperinflation or life-threatening respiratory acidosis persists despite optimal medical and ventilator management. Most prior reports describe the application of ECCO2R to rapid-onset asthma exacerbation, requiring a short duration of extracorporeal support. We report two patients with refractory status asthmaticus managed with ECCO2R, emphasizing the use of modern extracorporeal technology, cannulation technique and management protocols, which may improve the risk-to-benefit profile of this strategy. This report highlights the challenges in managing patients with distinct asthma exacerbation phenotypes. The potential need for prolonged device support may alter provider expectations and offers a new perspective of the role of ECCO2R for status asthmaticus.

show abstract

Section: Introductionmentioning

confidence: 99%

Extracorporeal carbon dioxide removal for refractory status asthmaticus: experience in distinct exacerbation phenotypes

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Although several case reports8–14 and one case series15 exist describing the successful use of ECLS for near-fatal adult status asthmaticus, it is unknown how often ECLS is actually used for life-threatening status asthmaticus, and an assessment of the outcomes of these patients has not been performed to date.…”

Section: Introductionmentioning

confidence: 99%

Outcomes Using Extracorporeal Life Support for Adult Respiratory Failure due to Status Asthmaticus

Mikkelsen

Woo²,

Sager³

et al. 2009

ASAIO Journal

View full text Add to dashboard Cite

Our objective was to describe the outcomes for extracorporeal life support (ECLS) use in adult respiratory failure due to status asthmaticus and to determine whether ECLS use in status asthmaticus is associated with greater survival than other indications for ECLS. This retrospective cohort study used the multi-center, international extracorporeal life support organization registry. The study population included 1257 adults with respiratory failure requiring ECLS. Status asthmaticus was the primary indication for ECLS in 24 patients. 83.3% of asthmatics survived to hospital discharge, compared to 50.8% of non-asthmatics (n=1233) (OR favoring survival for asthmatics = 4.86, 95%CI 1.65–14.31, p=0.004). The survival advantage for asthmatics remained significant after adjustment for potential confounders. Complications were noted in 19 of 24 asthmatics (79.2%). In conclusion, we found that status asthmaticus, as an indication for ECLS in adult respiratory failure, appeared to be associated with greater survival than other indications for ECLS. However, complications are common and whether ECLS confers a survival advantage compared to other salvage treatment options remains unknown. More detailed information and complete reporting of ECLS use for status asthmaticus are needed to determine whether and when the potentially life-saving intervention of ECLS should be initiated in the asthmatic failing conventional therapy.

show abstract

“…The use of ECMO in patients with severe acute respiratory failure first took place in the 1970s in California5 and was introduced in the UK in 1989. The first case reported to be successfully treated with ECMO was published in 1981 6. Status asthmatics has been recognised as an indication for ECMO in adult respiratory failure and appears to be associated with greater survival than other indications for ECMO.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation (ECMO) for near-fatal asthma refractory to conventional ventilation

Maqsood

Patel

2018

BMJ Case Reports

View full text Add to dashboard Cite

We describe a case of near-fatal asthma, treated successfully by initiation of extracorporeal membrane oxygenation (ECMO). A 29-year-old woman, known asthmatic on steroid inhalers, inhaled/nebulised bronchodilators, long-term oral prednisolone, theophylline and montelukast, presented with acute shortness of breath. She deteriorated following initial treatment with nebulised bronchodilators and magnesium sulfate requiring intubation and mechanical ventilation. Severe bronchospasm ensued following mechanical ventilation and peak airway pressures remained at 55 cm HO with intrinsic positive end expiratory pressure(PEEP) of 14 cm HO. Despite treatment with sedation, paralysis, intravenous salbutamol and inhaled sevoflurane, her condition deteriorated. She was commenced on mobile ECMO by the retrieval team. While on ECMO, her CO normalised within 48 hours. She was extubated within 72 hours of initiating ECMO and was discharged to the ward next day. We reiterate that ECMO should be considered sooner for status asthmatics not responding to maximal pharmacological therapy and ventilatory support to prevent ongoing lung injury and mortality.

show abstract

Extracorporeal Membrane Oxygenator Support in a Case of Severe Status Asthmaticus

Cited by 41 publications

References 12 publications

Extracorporeal carbon dioxide removal for refractory status asthmaticus: experience in distinct exacerbation phenotypes

Extracorporeal carbon dioxide removal for refractory status asthmaticus: experience in distinct exacerbation phenotypes

Outcomes Using Extracorporeal Life Support for Adult Respiratory Failure due to Status Asthmaticus

Extracorporeal membrane oxygenation (ECMO) for near-fatal asthma refractory to conventional ventilation

Contact Info

Product

Resources

About