儿科重症监护病房通过flow - 1呼吸机诱导七氟醚治疗哮喘状态:1例报告和文献综述

IF 1.3 4区 医学 Q3 ALLERGY
Journal of Asthma Pub Date : 2025-08-01 Epub Date: 2025-03-27 DOI:10.1080/02770903.2025.2482995
Ahmani DoDoo, Melissa Cregan, Kailey A Remien, Ambrish Patel
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引用次数: 0

摘要

状态哮喘是一种严重的哮喘加重,通常伴有高碳、缺氧和呼吸性酸中毒,对常规治疗无反应。无创正压通气是第一种呼吸支持方式。吸入麻醉剂是一种非标准的治疗选择,一旦患者插管,可考虑其支气管扩张剂特性。病例报告:我们报告一名14岁的青少年,有严重的持续性哮喘病史,以哮喘状态被送入儿科重症监护病房(PICU)。患者需要插管,用七氟醚诱导,并使用Flow-i呼吸机进行机械通气。讨论:状态哮喘被描述为对反复使用β受体激动剂难治性的严重哮喘,而近致死性哮喘被描述为需要插管和机械通气的恶化。当机械通气和常规治疗不足时,可以考虑吸入麻醉剂和体外膜氧合(ECMO)。这篇文章检查使用七氟醚作为治疗方式的儿童患者状态哮喘突出的治疗方法和结果。结论:吸入麻醉气体及先进麻醉机的应用可使难治性哮喘患者的治疗方法多样化,提高治疗效果。在持续监测血流动力学的情况下,麻醉机可能是PICU内治疗难治性哮喘的一个完整的治疗选择,而不需要体外生命支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sevoflurane-induction via the Flow-i ventilator in the pediatric intensive care unit for the treatment of status asthmaticus: a case report and literature review.

Introduction: Status asthmaticus is a severe asthma exacerbation commonly associated with hypercarbia, hypoxia, and respiratory acidosis that can be unresponsive to conventional therapies. Non-invasive positive pressure ventilation is utilized as the first modality of respiratory support. Inhaled anesthetic agents are non-standard treatment options which can be considered for their bronchodilator properties once the patient is intubated.

Case report: We present a 14-year-old adolescent with a history of severe persistent asthma who was admitted to the pediatric intensive care unit (PICU) in status asthmaticus. The patient required intubation, was induced with sevoflurane, and mechanically ventilated with the Flow-i ventilator.

Discussion: Status asthmaticus is described as severe asthma that is refractory to repeated administration of beta-agonists, while near-fatal asthma is described as exacerbations requiring intubation and mechanical ventilation. When mechanical ventilation and conventional therapies are inadequate, inhalational anesthetics and extracorporeal membrane oxygenation (ECMO) are considered. This article examines the use of sevoflurane as a treatment modality for pediatric patients with status asthmaticus highlighting the therapeutic approach and outcome.

Conclusion: The use of inhaled anesthetic gases and advanced anesthesia machines can diversify and enhance treatment for patients with refractory status asthmaticus. With continuous monitoring of hemodynamics, anesthesia machines may be an integral therapeutic option for treating refractory status asthmaticus within the PICU without the need for extracorporeal life support.

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来源期刊
Journal of Asthma
Journal of Asthma 医学-过敏
CiteScore
4.00
自引率
5.30%
发文量
158
审稿时长
3-8 weeks
期刊介绍: Providing an authoritative open forum on asthma and related conditions, Journal of Asthma publishes clinical research around such topics as asthma management, critical and long-term care, preventative measures, environmental counselling, and patient education.
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