Mechanical ventilation in patients with acute severe asthma

Mansel, J. Keith; Stogner, Steven W.; Petrini, Marcy F.; Norman, Joe R.

doi:10.1016/0002-9343(90)90096-v

Cited by 91 publications

(26 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The complication rate is high and includes pneumothorax (8,9), barotrauma (10), and myopathy (10). More than half of the significant morbidity and mortality associated with severe asthma occur during or immediately following endotracheal intubation (1,2), and the use of mechanical ventilation during an asthma exacerbation is associated with an increased risk of death (6,7,12). In this study, almost half of the children intubated for status asthmaticus experienced a complication during the course of mechanical ventilation.…”

Section: Discussionmentioning

confidence: 68%

“…Modest degrees of hypercarbia are generally well tolerated in nonintubated children with status asthmaticus (4), and reliable and reproducible measures of pulmonary function are lacking in ill children (1)(2)(3). In addition, endotracheal intubation and mechanical ventilation can have significant adverse effects in asthmatic patients (5)(6)(7)(8)(9)(10)(11)(12). The presence of an endotracheal tube can aggravate bronchospasm, and 10 -26% of children ventilated for status asthmaticus have been reported to experience serious complications (8 -11).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Endotracheal intubation and pediatric status asthmaticus: Site of original care affects treatment*

Carroll

Smith²,

Collins³

et al. 2007

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 68%

mentioning

confidence: 99%

Endotracheal intubation and pediatric status asthmaticus: Site of original care affects treatment*

Carroll

Smith²,

Collins³

et al. 2007

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…[2][3][4][5] This retrospective analysis emphasizes the importance of status asthmaticus in the medical intensive care unit.…”

Section: Discussionmentioning

confidence: 99%

“…1 The reported mortality of patients admitted to the intensive care unit for status asthmaticus has ranged from 0 to 38%. [2][3][4][5] A change in the ventilatory approach to the management of status asthmaticus, with attempts to reduce dynamic hyperinflation, has been credited with the improved survival rates reported in recent series. 1 ICU management of status asthmaticus remains fraught with potential complications from the airways disease as well as from ICU interventions.…”

Section: Introductionmentioning

confidence: 99%

Status asthmaticus: a large MICU experience

Shapiro

McLeroth

2002

Clinical Intensive Care

View full text Add to dashboard Cite

Objective: To review the management and outcome of patients admitted to the Medical Intensive Care Unit (MICU) with status asthmaticus. Design: Retrospective chart review of all patients admitted to the MICU of a New York City hospital with status asthmaticus during the 5-year period 1995-1999. Results: During the 5-year period, there were 88 MICU admissions for status asthmaticus; the records of 87 were available for retrospective review. The study group comprised 63 women (including three pregnant women) and 24 men, mean age of 45 years. Six patients underwent cardiopulmonary resuscitation prior to MICU admission. Mechanical ventilation was required in 87% of admissions. The approach to all intubated patients during this time period was permissive hypercapnia. Mortality was 2 (2%) patients, both of whom sustained a pre-hospital cardiopulmonary arrest. Median duration of mechanical ventilation was 3 days. Significant complications included barotrauma, hypotension, ventilator-associated pneumonia, anoxic encephalopathy, and myopathy. Conclusion: We report a large experience with patients admitted to the MICU for management of status asthmaticus. Despite the many complications associated with intensive care of status asthmaticus, the mortality was low and related to prehospital cardiopulmonary arrest

show abstract

“…Nonetheless, its exact place in the treatment of acute severe asthma remains to be defined, since treatment with bronchodilators and corticosteroids usually brings about rapid improvement. However, as mortality in patients hospitalized for severe asthma is mostly due to complications of intubation and mechanical ventilation (24,25), any therapeutic option likely to reduce the need for intubation in patients refractory to standard treatment would be welcome. Given the presently available data, He-O 2 should probably be reserved for those patients with features of severe asthma (26) failing to improve after 30 min of aggressive bronchodilator and corticosteroid treatment, and to intubated patients with high inflation pressures, severe hypercapnia or hemodynamic instability (24,27).…”

Section: S Asthmamentioning

confidence: 99%