DOI: 10.1097/01.pcc.0000449166.76822.f8
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Issn Print: 1529-7535
Publication Date: 2014/05/01
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Excerpt
Aims: To demonstrate efficacy of sevoflurane inhalation therapy on status asthmaticus by case report.
Methods: This is the case report.
Results: Case 1: Noninvasive positive pressure ventilation (NPPV) was used to treat 4-year-girl who had not been improved with inhaled isoproterenol and intravenous corticosteroids. The patient underwent chest tube insertion and was intubated as NPPV resulted in tension pneumothorax. Sevoflurane was used as rescue maneuver since the patient continued ventilatory failure despite appropriate mechanical ventilation and aggressive medical therapy. The concentration 2% of sevoflurane improved the P/F ratio 65 to 285 in 8 hours.
Case 2: 10-year-boy who had been intubated because of acute severe asthma resulted in tension pneumothorax. Ventilatory failure was not getting better in spite of chest tube insertion and other medical therapy. The use of 1% sevoflurane improved the P/F ratio 120 to 397 in 16 hours and the patients succeeded in extubation.
Conclusions: The use of inhalational anesthetics may be tried as a rescue maneuver in children with acute severe asthma exacerbations who have continued ventilatory failure despite appropriate mechanical ventilation and aggressive medical therapy before extracorporeal membrane oxygenation although this requires the corporation with anesthesiologist and medical engineer.
