Management of respiratory failure in patients with asthma.
The goal of management of patients with respiratory failure is to restore them to a state of quiet breathing, without complication. This goal is often achieved by pharmacotherapy alone. Inhaled albuterol sulfate, oxygen, and systemic corticosteroids are mainstays of acute care drug management, whereas other data support the use of inhaled steroids, ipratropium bromide, magnesium sulfate, theophylline, and heliox. Assisted ventilation by face mask or endotracheal tube may be required in refractory patients. In intubated patients, a ventilatory strategy that prolongs exhalation time and accepts hypercapnia minimizes lung hyperinflation and generally results in a good outcome. Acute asthma often represents failure of outpatient management; key aspects of the outpatient program should be addressed in the acute care setting to help prevent recurrent attacks.
Gluckman
T J
TJ
Division of Pulmonary and Critical Care Medicine, Northwestern University Medical School, Chicago, IL, USA.
Corbridge
T
T
D000280:Administration, Inhalation; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000150:complications* / Q000517:prevention & control; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006371:Helium / Q000627:therapeutic use; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology; D007442:Intubation, Intratracheal; D009241:Ipratropium / Q000627:therapeutic use; D008168:Lung / Q000503:physiopathology; D008278:Magnesium Sulfate / Q000627:therapeutic use; D008397:Masks; D010100:Oxygen / Q000627:therapeutic use; D010102:Oxygen Inhalation Therapy; D012119:Respiration; D012131:Respiratory Insufficiency / Q000188:drug therapy / Q000628:therapy*; D013806:Theophylline / Q000627:therapeutic use
D001993:Bronchodilator Agents; D002121:Calcium Channel Blockers; D005938:Glucocorticoids; D006371:Helium; C038949:heliox; D008278:Magnesium Sulfate; D013806:Theophylline; D009241:Ipratropium; D000420:Albuterol; D010100:Oxygen