Analytic review: management of life-threatening asthma in adults.
Asthma remains a troubling health problem despite the availability of effective treatment. A small but significant number of asthmatics experience life-threatening attacks culminating in intensive care unit admission. Standard treatment includes high dose systemic corticosteroids and inhaled bronchodilators. Patients with especially severe attacks may develop respiratory failure and need endotracheal intubation and mechanical ventilation. Severe airway obstruction may lead to dynamic hyperinflation and the possibility of hemodynamic collapse and barotrauma. Fortunately, most intubated asthmatics survive if physicians adhere to key management principles intended to avoid or minimize hyperinflation. The purpose of this review is to discuss the pathogenesis of life-threatening asthma and to provide practical guidance to promote rationale, safe, and effective management.
Mannam
Praveen
P
Pulmonary and Critical Care Section, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
Siegel
Mark D
MD
D000328:Adult; D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000453:epidemiology; D003131:Combined Modality Therapy; D006801:Humans; D008168:Lung / Q000503:physiopathology; D010102:Oxygen Inhalation Therapy; D012121:Respiration, Artificial; D013224:Status Asthmaticus / Q000150:complications / Q000188:drug therapy / Q000628:therapy*
D018927:Anti-Asthmatic Agents