title: Sevoflurane therapy for life-threatening asthma in children.
abstract: BACKGROUND
  Asthma is a common disease in children and often develops early in life. This multicentre retrospective case series describe the use and effectiveness of sevoflurane inhalation therapy in a series of children with severe asthma in the paediatric intensive care unit (PICU).
  
  
  METHODS
  Seven children ranging from 4 to 13 yr of age admitted to the PICU of two tertiary care hospitals in the Netherlands were included. They all were admitted with the diagnosis of severe asthma requiring invasive mechanical ventilation and were treated with sevoflurane inhalation therapy.
  
  
  RESULTS
  The median (range) Pco2 level at the start, after 2 h, and at the end of sevoflurane treatment were 14 (5.1-24.8), 9.8 (5.4-17.0), and 6.2 (4.5-11.4) kPa (P=0.05) while the median (range) pH was 7.02 (6.97-7.36), 7.18 (7.04-7.35), and 7.43 (7.15-7.47) kPa (P=0.01), respectively. The median (range) peak pressure values declined from 30 (23-56) to 20.4 (14-33) cm H2O (P=0.03). No severe adverse effects besides hypotension, with sufficient response to norepinephrine treatment, were seen.
  
  
  CONCLUSIONS
  Sevoflurane inhalation corrects high levels of Pco2 and provides clinical improvement in mechanically ventilated children with life-threatening asthma who fail to respond to conventional treatment.
authors.affiliation: Department of Intensive Care Medicine and.
authors.forename: D
authors.initials: D
authors.lastname: Schutte
authors.forename: A M
authors.initials: AM
authors.lastname: Zwitserloot
authors.forename: R
authors.initials: R
authors.lastname: Houmes
authors.forename: M
authors.initials: M
authors.lastname: de Hoog
authors.forename: J M
authors.initials: JM
authors.lastname: Draaisma
authors.forename: J
authors.initials: J
authors.lastname: Lemson
mesh_terms: D000293:Adolescent; D018685:Anesthetics, Inhalation / Q000627:therapeutic use*; D001249:Asthma / Q000097:blood / Q000188:drug therapy*; D002245:Carbon Dioxide / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods; D004341:Drug Evaluation / Q000379:methods; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008738:Methyl Ethers / Q000627:therapeutic use*; D010313:Partial Pressure; D012138:Respiratory Therapy / Q000379:methods; D012189:Retrospective Studies; D000077149:Sevoflurane; D016896:Treatment Outcome
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D002245:Carbon Dioxide; D000077149:Sevoflurane
keywords: anesthetics, inhalation; asthma; pediatrics; sevoflurane