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Article
Noninvasive Ventilation in Severe Acute Asthma
Respiratory Care
(2014)
Abstract
Noninvasive ventilation (NIV) in severe acute asthma is controversial but may benefit this population by preventing intubation. We report on a 35-year-old male asthma patient who presented to our emergency department via emergency medical services. The patient was responsive, diaphoretic, and breathing at 35 breaths/min on 100% oxygen with bag-mask assistance, with SpO2 88%, heart rate 110 –120 beats/min, blood pressure 220/110 mm Hg, and temperature 35.8°C. NIV at 12/5 cm H2O and FIO2 0.40 was applied, and albuterol at 40 mg/h was initiated. Admission arterial blood gas revealed a pH of 6.95, PaCO2 126 mm Hg, and PaO2 316 mm Hg. After 90 min of therapy, PaCO2 was 63 mm Hg. Improvement continued, and NIV was stopped 4 h following presentation. NIV tolerance was supported with low doses of lorazepam. The patient was transferred to the ICU, moved to general care the next morning, and discharged 3 days later. We attribute our success to close monitoring in a critical care setting and the titration of lorazepam. K
Keywords
- noninvasive,
- ventilation,
- asthma,
- ARF,
- continuous albuterol,
- capnography,
- mechanical ventilation,
- intubation,
- sedation
Disciplines
Publication Date
October, 2014
DOI
https://doi.org/10.4187/respcare.02730
Citation Information
Jhaymie L. Cappiello and Michael B. Hocker. "Noninvasive Ventilation in Severe Acute Asthma" Respiratory Care Vol. 59 Iss. 10 (2014) p. e149 - e152 Available at: http://works.bepress.com/jhaymie-cappiello/8/