Clinical review: Mechanical ventilation in severe asthma.
Respiratory failure from severe asthma is a potentially reversible, life-threatening condition. Poor outcome in this setting is frequently a result of the development of gas-trapping. This condition can arise in any mechanically ventilated patient, but those with severe airflow limitation have a predisposition. It is important that clinicians managing these types of patients understand that the use of mechanical ventilation can lead to or worsen gas-trapping. In this review we discuss the development of this complication during mechanical ventilation, techniques to measure it and strategies to limit its severity. We hope that by understanding such concepts clinicians will be able to reduce further the poor outcomes occasionally related to severe asthma.
Stather
David R
DR
InterDepartmental Division of Critical Care Medicine, Department of Medicine, Mount Sinai Hospital, University Health Network, University of Toronto, Toronto, Canada. davestather@yahoo.ca
Stewart
Thomas E
TE
D001249:Asthma / Q000503:physiopathology / Q000628:therapy*; D002985:Clinical Protocols; D003131:Combined Modality Therapy / Q000379:methods; D003422:Critical Care / Q000379:methods; D006801:Humans; D008176:Lung Volume Measurements / Q000379:methods; D018579:Patient Selection; D011175:Positive-Pressure Respiration / Q000379:methods; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial / Q000379:methods* / Q000592:standards