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 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.

EXTRACORPOREAL LIFE SUPPORT FOR STATUS ASTHMATICUS

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 261-261
Author(s):  
Thomas Bell
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Status Asthmaticus ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Alternative Therapy ◽  
Treatment Resistant ◽  
Venovenous Bypass ◽  
Primary Indication ◽  
Additional Therapy

Purpose of the Study. This report presents the experience with one case of status asthmaticus who failed to respond to mechanical ventilation and was successfully managed with extracorporeal life support (ECLS) using venovenous bypass. The purpose is to inform the practitioner of an additional therapy, potentially of benefit, in management of asthma complicated by treatment-resistant respiratory failure. Methods. Low volume venovenous bypass with extracorporeal life support resolved severe respiratory failure in a 23-year-old female asthmatic over a 22-hour period after failure of 5 hours of mechanical ventilation. Bypass was initiated remotely by an ECLS team using a portable ECLS circuit before the 180-mile transport to the "nearby" center. Details of the technique are presented. Conclusion and Reviewer's Comments. This may be the first instance where asthma was the primary indication for ECLS; other asthmatics have been so treated, but for other complicating conditions like pneumonia and adult respiratory distress syndrome. This report provides a further alternative therapy, even in somewhat remote areas, for asthma-caused respiratory failure.

scholarly journals Highlights from the Respiratory Failure and Mechanical Ventilation 2020 Conference

2021 ◽  
Vol 7 (1) ◽  
pp. 00752-2020
Author(s):  
Adelaide Withers ◽  
Tiffany Choi Ching Man ◽  
Rebecca D'Cruz ◽  
Heder de Vries ◽  
Christoph Fisser ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Patient Selection ◽  
Treatment Options ◽  
Early Career ◽  
European Respiratory Society ◽  
Diagnostic Strategies ◽  
Adults And Children ◽  
International Experts

The Respiratory Intensive Care Assembly of the European Respiratory Society organised the first Respiratory Failure and Mechanical Ventilation Conference in Berlin in February 2020. The conference covered acute and chronic respiratory failure in both adults and children. During this 3-day conference, patient selection, diagnostic strategies and treatment options were discussed by international experts. Lectures delivered during the event have been summarised by Early Career Members of the Assembly and take-home messages highlighted.

scholarly journals Outcomes and characteristics of COVID-19 patients treated with CPAP/ HFNO outside of the intensive care setting

2021 ◽  
pp. 00318-2021
Author(s):  
Dominic L Sykes ◽  
Michael G Crooks ◽  
Khaing Thu Thu ◽  
Oliver I Brown ◽  
Theodore J p Tyrer ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Care Setting ◽  
Treatment Options ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Support ◽  
Intensive Care Setting ◽  
Non Invasive ◽  
Significant Difference

BackgroundContinuous Positive Airway Pressure (CPAP) and High Flow Nasal Oxygen (HFNO) have been used to manage hypoxaemic respiratory failure secondary to COVID-19 pneumonia. Limited data are available for patients treated with non-invasive respiratory support outside of the intensive care setting.MethodsIn this single-centre observational study we observed the characteristics, physiological observations, laboratory tests, and outcomes of all consecutive patients with COVID-19 pneumonia between April 2020 and March 2021 treated with non-invasive respiratory support outside of the intensive care setting.ResultsWe report the outcomes of 140 patients (Mean Age=71.2 [sd=11.1], 65% Male [n=91]) treated with CPAP/HFNO outside of the intensive care setting. Overall mortality was 59% and was higher in those deemed unsuitable for mechanical ventilation (72%). The mean age of survivors was significantly lower than those who died (66.1 versus 74.4 years, p<0.001). Those who survived their admission also had a significantly lower median Clinical Frailty Score than the non-survivor group (2 versus 4, p<0.001). We report no significant difference in mortality between those treated with CPAP (n=92, mortality: 60%) or HFNO (n=48, mortality: 56%). Treatment was well tolerated in 86% of patients receiving either CPAP or HFNO.ConclusionsCPAP and HFNO delivered outside of the intensive care setting are viable treatment options for patients with hypoxaemic respiratory failure secondary to COVID-19 pneumonia, including those considered unsuitable for invasive mechanical ventilation. This provides an opportunity to safeguard intensive care capacity for COVID-19 patients requiring invasive mechanical ventilation.

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