Endotracheal intubation and mechanical ventilation in severe asthma.
OBJECTIVE
To determine the occurrence rate of complications and mortality in patients with severe asthma requiring endotracheal intubation and mechanical ventilation.


METHODS
Retrospective review of medical records from September 1982 to July 1988.


METHODS
Urban, teaching hospital serving primarily indigent patients.


METHODS
Fifty-seven adult patients with asthma requiring tracheal intubation and mechanical ventilation.


METHODS
None.


RESULTS
Fifty-seven patients requiring tracheal intubation and mechanical ventilation during 69 hospital admissions were identified. Medication noncompliance and upper respiratory tract infections were recorded as the most frequent precipitating events for exacerbation of asthma. Forty-nine intubations were initiated because of a clinical diagnosis of respiratory distress, but multiple indications were present in 42 admissions. One or more complications occurred in 31 episodes of endotracheal intubation and mechanical ventilation (45%). Death occurred in four (6%) of 69 admissions. Three of the four deaths occurred in patients who had a cardiorespiratory arrest before hospital admission.


CONCLUSIONS
While complications occurred in 45% of patients with severe asthma requiring intubation and mechanical ventilation, the mortality rate was low. We conclude that intubation and mechanical ventilation in patients with life-threatening asthma are safe and beneficial interventions.
Zimmerman
J L
JL
Department of Medicine, Baylor College of Medicine, Houston, TX.
Dellinger
R P
RP
Shah
A N
AN
Taylor
R W
RW
D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D004630:Emergencies; D005260:Female; D006801:Humans; D015994:Incidence; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology