Combined bronchoscopy and mucolytic therapy for patients with severe refractory status asthmaticus on mechanical ventilation: A case report and review of the literature

1994 ◽  
Vol 22 (11) ◽  
pp. 1880-1883 ◽  
Author(s):  
Craig A. Henke ◽  
Marshall Hertz ◽  
Paul Gustafson
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Status Asthmaticus ◽  
Review Of The Literature ◽  
Refractory Status

scholarly journals Influenza A triggered status asthmaticus requiring emergency ECMO

2016 ◽  
Vol 73 (4) ◽  
Author(s):  
F. Guarracino ◽  
M. Stefani ◽  
P. Maremmani ◽  
M. Corini ◽  
S. Pini ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Respiratory Failure ◽  
Influenza A Virus ◽  
Influenza A ◽  
Status Asthmaticus ◽  
Severe Pneumonia ◽  
Refractory Status ◽  
Threatening Condition ◽  
Life Threatening

We describe a case of acute respiratory failure due to severe pneumonia triggered by the influenza A virus, rapidly evolving into a refractory status asthmaticus requiring emergent ECMO assistance, in order to facilitate the clinical management of patients suffering from this rare but life-threatening condition. This case report demonstrates that infection with influenza A virus can present with severe pneumonia and status asthmaticus refractory to medical and ventilatory treatment. When medical treatment and mechanical ventilation fail, extracorporeal membrane oxygenation therapy should not be delayed as it will avoid injury resulting from inadequate mechanical ventilation and lung hyperinflation.

scholarly journals A spicy status: Synthetic cannabinoid (spice) use and new-onset refractory status epilepticus—A case report and review of the literature

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774520 ◽  
Author(s):  
Marc-Alain Babi ◽  
Christopher P Robinson ◽  
Carolina B Maciel
Keyword(s):  
Case Report ◽  
Status Epilepticus ◽  
Synthetic Cannabinoids ◽  
Refractory Status Epilepticus ◽  
Synthetic Cannabinoid ◽  
Severe Toxicity ◽  
Acute Psychosis ◽  
Review Of The Literature ◽  
Refractory Status ◽  
New Onset

Synthetic cannabinoids refer to a wide variety of chemicals engineered to bind cannabinoid receptors (CB1 and CB2) and mimic the effects of delta-9-tetrahydrocanabinol. The potential for severe toxicity and limited in vivo data make synthetic cannabinoid intake an important public health and safety concern. Neurologic toxidromes associated with their use include mental status changes, panic attacks, memory distortions, acute psychosis (e.g. paranoia, delusional thoughts), disorganized behavior, and suicidal and homicidal thoughts. Systemic complications include vomiting, sinus tachycardia, myocardial infarction, and acute kidney injury. Seizures are common; however, status epilepticus is not widely reported. In this case report, we describe a patient who developed acute psychosis and new-onset refractory status epilepticus necessitating emergent neurological life-support and prolonged admission to an intensive care unit following abuse of synthetic cannabinoids. We include a brief review of the literature to prepare the treating clinician for the broad clinical spectrum of this increasingly common intoxication.

scholarly journals Enteral Topiramate in a Pediatric Patient with Refractory Status Epilepticus: A Case Report and Review of the Literature

2014 ◽  
Vol 19 (4) ◽  
pp. 317-324
Author(s):  
Chasity M. Shelton ◽  
Elizabeth L. Alford ◽  
Stephanie Storgion ◽  
James Wheless ◽  
Stephanie J. Phelps
Keyword(s):  
Case Report ◽  
Metabolic Acidosis ◽  
Status Epilepticus ◽  
Pediatric Patient ◽  
Treatment Option ◽  
Refractory Status Epilepticus ◽  
Convulsive Status Epilepticus ◽  
Review Of The Literature ◽  
Refractory Status

We describe the use of topiramate in a healthy 12-year-old (88-kg) male who developed refractory generalized convulsive status epilepticus. Seizures persisted despite aggressive use of benzodiazepines (intravenous lorazepam; oral clorazepate), barbiturates (i.e., phenobarbital, pentobarbital), and hydantoins. The child's seizures were controlled with nasogastrically administered topiramate in doses up to 500 mg twice daily (11.4 mg/kg/day). The patient did not display any clinical or laboratory signs of metabolic acidosis while receiving topiramate. Topiramate should be considered as a treatment option in refractory status epilepticus.

scholarly journals Pulmonary interstitial emphysema: a case report and review of the literature

2013 ◽  
Vol 46 (5) ◽  
pp. 317-319 ◽  
Author(s):  
Mauricio Kauark Amoedo ◽  
Luciana Volpon Soares Souza ◽  
Antônio Soares Souza ◽  
Arthur Soares Souza Júnior ◽  
Edson Marchiori
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Early Diagnosis ◽  
Preterm Infants ◽  
Rare Condition ◽  
Diagnosis And Treatment ◽  
Review Of The Literature ◽  
Pulmonary Interstitial Emphysema ◽  
Interstitial Emphysema ◽  
Low Weight

Pulmonary interstitial emphysema is a rare condition that generally affects low-weight preterm infants submitted to mechanical ventilation. The prognosis is variable, depending on early diagnosis and treatment. The radiologist plays a key role in this scenario. The authors report a case of persistent pulmonary interstitial emphysema, describing the main characteristics of such entity.

Alternatives to Standard Status Asthmaticus Therapy

1997 ◽  
Vol 10 (3) ◽  
pp. 186-199
Author(s):  
Julie A. Everett
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Ipratropium Bromide ◽  
Status Asthmaticus ◽  
Treatment Options ◽  
Alternative Therapies ◽  
Morbidity And Mortality ◽  
Beta Agonists ◽  
Refractory Status ◽  
Treatment Morbidity

Even with the currently available treatment, morbidity and mortality from asthma continues to rise. Patients with status asthmaticus who do not respond to standard therapy are at risk for respiratory failure and possible mechanical ventilation. Treatment options for refractory status asthmaticus remain limited and alternative and controversial therapies may need to be considered. Alternative therapies include continuous nebulized beta-agonists, ipratropium bromide, intravenous magnesium sulfate, ketamine, or heliox. Morbidity and mortality may be decreased by increased utilization of these alternative therapies. Pharmacists can play a key role in monitoring and recommending new and alternate therapies.

scholarly journals Tracheomegaly and tracheosephagial fistula following mechanical ventilation: A case report and review of the literature

2016 ◽  
Vol 17 ◽  
pp. 86-89 ◽  
Author(s):  
Canan Kucuk ◽  
Kemal Arda ◽  
Naim Ata ◽  
Mustafa Hamidullah Turkkani ◽  
Özgür Ömer Yildiz
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Review Of The Literature

Combined Modalities in the Treatment of an Unresponsive Patient with Adult Status Asthmaticus

1995 ◽  
Vol 10 (3) ◽  
pp. 142-144
Author(s):  
Sabena Toor ◽  
Jeff Borenstein ◽  
Zab Mohsenifar
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Asthma Exacerbation ◽  
Status Asthmaticus ◽  
High Dose ◽  
Barbiturate Coma ◽  
Severe Asthma Exacerbation ◽  
Adult Status ◽  
Successful Extubation

We present a 42-year-old woman with status asthmaticus who required mechanical ventilation and a combination of maneuvers, including barbiturate coma, general anesthesia, high-dose steroids, bronchoscopic pulmonary toilet, and helium-oxygen ventilation, resulting in successful extubation and eventual hospital discharge. This case report illustrates the possible role of combination therapy in the management of severe asthma exacerbation.

scholarly journals Decapneization as supportive therapy for the treatment of status asthmaticus: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Rossella Esposito ◽  
Irene Esposito ◽  
Francesco Imperatore ◽  
Giovanni Liguori ◽  
Fabrizio Gritti ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Tidal Volume ◽  
Status Asthmaticus ◽  
Invasive Mechanical Ventilation ◽  
Medical Emergency ◽  
Dynamic Hyperinflation ◽  
Low Tidal Volume ◽  
Low Tidal Volume Ventilation ◽  
Volume Ventilation

Abstract Background Acute severe asthma is a life-threatening medical emergency. Characteristics of asthma include increased airway resistance and dynamic pulmonary hyperinflation that can manifest in dangerous levels of hypercapnia and acidosis, with significant mortality and morbidity. Severe respiratory distress can lead to endotracheal intubation followed by mechanical ventilation, which can cause increased air trapping with dynamic hyperinflation, predisposing the lungs to barotraumas. Case presentation The present case report describes the use of the minimally invasive ECCO2R ProLUNG® (Estor) with protective low-tidal-volume ventilation, in a Caucasian patient with near-fatal asthma and with no response to conventional therapy. Conclusions Since hypercarbia rather than hypoxemia is the primary abnormality in status asthmaticus, a rescue therapeutic strategy combining the ECCO2R membrane ProLUNG® (Estor) with ultra-protective low-tidal-volume ventilation can be successfully applied to limit the risk of severe barotrauma during invasive mechanical ventilation. ECCO2R ProLUNG® is a partial respiratory support technique that, based on the use of an extracorporeal circuit with a gas-exchange membrane, achieves relevant CO2 clearance directly from the blood using double-lumen venous-venous vascular access, at blood flow in the range of 0.4–1.0 L/minute.

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