Document Detail


Prolonged sevoflurane inhalation therapy for status asthmaticus in an infant.
MedLine Citation:
PMID:  18363624     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 3-month-old boy with retractive breathing from his birth was scheduled for a rigid bronchoscopic examination. Anesthesia was induced and maintained with sevoflurane. The examination revealed a slight laryngomalacia which was not compatible with his severe symptom. During the procedure, no respiratory deterioration occurred. He was once extubated in the operating room, however, developed severe desaturation immediately. He was reintubated at the scene and returned to the ward being mechanically ventilated and sedated. The next day, his respiratory condition worsened gradually. Conventional drugs including theophylline, corticosteroid and beta adrenergic agonist did not improve his deleterious condition. He became bradycardic and was on the verge of circulatory collapse as his lungs were unable to ventilate. Then, we commenced inhalation of sevoflurane using a standard anesthesia machine, which relieved him from ventilatory crisis. Although there were some difficulties in using anesthesia machine in the ICU, we could successfully manage mechanical ventilation. After the beginning of sevoflurane inhalation, his condition improved gradually. Discontinuation of sevoflurane was difficult and it took 94 h to wean from sevoflurane inhalation. Despite long duration of inhalation, no adverse effects of sevoflurane were observed except transient mild increase in liver transaminase. There have been very few reports on application of sevoflurane inhalation for such a long period in infants with bronchospasm. Moreover, measured serum fluoride concentration (24.2 micromol x l(-1)) during inhalation was well below harmful level. Sevoflurane inhalation is worth attempting and safe to treat life-threatening bronchospasm even in infants.
Authors:
Kazuhiro Watanabe; Taro Mizutani; Soichiro Yamashita; Yukihiro Tatekawa; Takahiro Jinbo; Makoto Tanaka
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-03-18
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  18     ISSN:  1460-9592     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-04-30     Completed Date:  2008-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  543-5     Citation Subset:  IM    
Affiliation:
Department of Critical Care Medicine, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
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MeSH Terms
Descriptor/Qualifier:
Anesthetics, Inhalation / administration & dosage*
Bronchial Spasm / drug therapy*,  etiology
Humans
Infant
Male
Methyl Ethers / administration & dosage*
Respiratory Therapy / methods
Status Asthmaticus / complications,  drug therapy*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane

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


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