What is status asthmaticus?
Status asthmaticus is a medical emergency, an extreme form of asthma exacerbation characterized by hypoxemia, hypercarbia, and secondary respiratory failure.
Is it safe to ventilate a patient with Status asthmaticus?
The problem is that airway pressures required to ventilate a patient in status asthmaticus will trigger alarms on standard ventilator settings. The following is an approach to set the ventilator over the phone, in such a way which is safe for the patient.
What is a favorable response to initial treatment of Status asthmaticus?
A favorable response to initial treatment of status asthmaticus should be a visible improvement in symptoms that sustains 30 minutes or beyond the last bronchodilator dose and a PEFR greater than 70% of predicted.
When should a patient with Status asthmaticus be intubated?
The decision to intubate a patient presenting with status asthmaticus is a clinical one and does not unequivocally require a blood gas assessment. If a patient continues to deteriorate despite initial pharmacologic treatment, a bedside assessment around the time window of response needs to be made.
What is refractory status asthmaticus?
Refractory status asthmaticus is the cause of rare cases of in-hospital death due to acute bronchial asthma. The most severe cases unresponsive to first, second and next line treatment may be fatal despite aggressive organ support with invasive ventilation and extracorporeal membrane oxygenation.
What are the mortality and morbidity associated with Status asthmaticus?
An estimated 3% to 16% of hospitalized adult asthmatic patients progress to respiratory failure requiring ventilatory support, although the statistics might be lower in children. Afessa et al. have reported a mortality of around 10% in the intensive care unit (ICU) patients admitted with status asthmaticus.
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