Document Detail


Mechanical ventilation for status asthmaticus in children.
MedLine Citation:
PMID:  2494314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We retrospectively reviewed the time course of recovery of pediatric patients in status asthmaticus who were undergoing mechanical ventilation for life-threatening respiratory failure to evaluate the results with current medications and technology. Ten patients between 2 and 18 years of age underwent intubation on 20 occasions. Mechanical ventilation was maintained for a mean of 2 days. Positive end-expiratory pressure was introduced in the recovery phase to prevent hypoxemia. Twelve episodes (Group 1) involved intubation less than 48 hours; in eight episodes (group 2) the patients required ventilatory support greater than 48 hours. The two groups did not differ in regard to age, pharmacologic therapy, preintubation arterial blood gas data, or initial ventilator settings, but the rise in pH and fall in Paco2 differed significantly over the first 12 hours of therapy. In the group 2 patients, peak pressures were not increased greater than 60 cm H2O despite elevated Paco2 values, and aggressive sodium bicarbonate therapy for pH correction was not pursued. Complications were few and all patients survived. We conclude that asthma patients have variable resolution of airway obstruction during mechanical ventilation and that controlled hypoventilation can be a safe therapy for the patients with more severe obstruction.
Authors:
G Dworkin; M Kattan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  114     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1989 Apr 
Date Detail:
Created Date:  1989-05-05     Completed Date:  1989-05-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  545-9     Citation Subset:  AIM; IM    
Affiliation:
Jack and Lucy Clark Department of Pediatrics, Mount Sinai Medical Center, New York, NY 10029.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Asthma / therapy*
Carbon Dioxide / blood
Child
Child, Preschool
Humans
Hydrogen-Ion Concentration
Intubation
Positive-Pressure Respiration
Respiration, Artificial*
Status Asthmaticus / therapy*
Time Factors
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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