Heliox for nonintubated acute asthma patients

Rodrigo, Gustavo J.; Rodrigo, Carlos; Pollack, Charles V.; Travers, Andrew

doi:10.1002/14651858.cd002884

Cited by 62 publications

(58 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, new evidence suggests certain beneficial effects in patients with more severe airway obstruction. 151 Given the relatively small patient numbers and few studies, there is still a role for heliox trials in refractory severe acute asthma.…”

Section: Helium-oxygen Mixture (Heliox)mentioning

confidence: 99%

Severe Acute Asthma Exacerbation in Children: A Stepwise Approach for Escalating Therapy in a Pediatric Intensive Care Unit

Nievas

Anand

2013

The Journal of Pediatric Pharmacology and Therapeutics

View full text Add to dashboard Cite

OBJECTIVES An increasing prevalence of pediatric asthma has led to increasing burdens of critical illness in children with severe acute asthma exacerbations, often leading to respiratory distress, progressive hypoxia, and respiratory failure. We review the definitions, epidemiology, pathophysiology, and clinical manifestations of severe acute asthma, with a view to developing an evidence-based, stepwise approach for escalating therapy in these patients. METHODS Subject headings related to asthma, status asthmaticus, critical asthma, and drug therapy were used in a MEDLINE search , supplemented by a manual search of personal files, references cited in the reviewed articles, and treatment algorithms developed within Le Bonheur Children's Hospital. RESULTS Patients with asthma require continuous monitoring of their cardiorespiratory status via noninvasive or invasive devices, with serial clinical examinations, objective scoring of asthma severity (using an objective pediatric asthma score), and appropriate diagnostic tests. All patients are treated with β-agonists, ipratropium, and steroids (intravenous preferable over oral preparations). Patients with worsening clinical status should be progressively treated with continuous β-agonists, intravenous magnesium, helium-oxygen mixtures, intravenous terbutaline and/or aminophylline, coupled with high-flow oxygen and non-invasive ventilation to limit the work of breathing, hypoxemia, and possibly hypercarbia. Sedation with low-dose ketamine (with or without benzodiazepines) infusions may allow better toleration of non-invasive ventilation and may also prepare the patient for tracheal intubation and mechanical ventilation, if indicated by a worsening clinical status. CONCLUSIONS Severe asthma can be a devastating illness in children, but most patients can be managed by using serial objective assessments and the stepwise clinical approach outlined herein. Following multidisciplinary education and training, this approach was successfully implemented in a tertiary-care, metropolitan children's hospital. INDEX TERMS asthma, child, critical care, infant, respiratory failure, status asthmaticus J Pediatr Pharmacol Ther 2013;18(2):88-104

show abstract

Section: Helium-oxygen Mixture (Heliox)mentioning

confidence: 99%

Severe Acute Asthma Exacerbation in Children: A Stepwise Approach for Escalating Therapy in a Pediatric Intensive Care Unit

Nievas

Anand

2013

The Journal of Pediatric Pharmacology and Therapeutics

View full text Add to dashboard Cite

show abstract

“…22 However, since that information is based on between-group comparisons and small studies, the conclusions are not definitive. 23 Often a question of effective nebulization time becomes a clinical question, and when to discontinue treatment. Two frequently seen practices are for clinicians and patients to tap the SVN to reduce dead volume and increase output, 24 while the second practice continues nebulization beyond device sputtering, to decrease dead volume.…”

Section: Other Nuances and Characteristics Of Svnsmentioning

confidence: 99%

The Science Guiding Selection of an Aerosol Delivery Device

Myers

2013

Respir Care

View full text Add to dashboard Cite

Aerosol therapy continues to be considered as one of the cornerstones of the profession of respiratory care, even after 60 years. Aerosol therapy serves as a critical intervention for both exacerbations and chronic maintenance for a variety of respiratory care conditions. Aerosol therapy uniquely blends both the art and science of medicine together to produce the practical and necessary clinical outcomes for patients with respiratory diseases. This review was presented as part of the New Horizons Symposium on how to guide the scientific selection of an appropriate aerosol device.

show abstract

“…101 However, since that information is based on between-group comparisons and small studies, the conclusions are not definitive. 102 It is also crucial for the clinician to be able to identify respiratory deterioration and failure, which is uncommon but can occur.…”

Section: In-patient Asthma Treatmentmentioning

confidence: 99%

Asthma: 2015 and Beyond

Myers

Tomasio

2011

Respir Care

View full text Add to dashboard Cite

SummaryAsthma is a multifactorial, chronic inflammatory disease of the airways. The knowledge that asthma is an inflammatory disorder has become a core fundamental in the definition of asthma. Asthma's chief features include a variable degree of air-flow obstruction and bronchial hyper-responsiveness, in addition to the underlying chronic airways inflammation. This underlying chronic airway inflammation substantially contributes to airway hyper-responsiveness, air-flow limitation, respiratory symptoms, and disease chronicity. However, this underlying chronic airway inflammation has implications for the diagnosis, management, and potential prevention of the disease. This review for the respiratory therapy community summarizes these developments as well as providing an update on asthma epidemiology, natural history, cause, and pathogenesis. This paper also provides an overview on appropriate diagnostic and monitoring strategies for asthma, pharmacology, and newer therapies for the future as well as relevant management of acute and ambulatory asthma, and a brief review of educational approaches.

show abstract

Heliox for nonintubated acute asthma patients

Cited by 62 publications

References 20 publications

Severe Acute Asthma Exacerbation in Children: A Stepwise Approach for Escalating Therapy in a Pediatric Intensive Care Unit

Severe Acute Asthma Exacerbation in Children: A Stepwise Approach for Escalating Therapy in a Pediatric Intensive Care Unit

The Science Guiding Selection of an Aerosol Delivery Device

Asthma: 2015 and Beyond

Contact Info

Product

Resources

About