Noninvasive ventilation in severe acute asthma

Jhaymie L. Cappiello, Michael Brian Hocker

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)e149-e152
JournalRespiratory Care
Volume59
Issue number10
DOIs
StatePublished - Oct 1 2014

Fingerprint

Noninvasive Ventilation
Asthma
Lorazepam
Albuterol
Emergency Medical Services
Critical Care
Masks
Intubation
Hospital Emergency Service
Respiration
Heart Rate
Gases
Oxygen
Blood Pressure
Temperature
Population
Therapeutics

Keywords

  • ARF
  • Asthma
  • Capnography
  • Continuous albuterol
  • Intubation
  • Mechanical ventilation
  • Noninvasive
  • Sedation
  • Ventilation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Noninvasive ventilation in severe acute asthma. / Cappiello, Jhaymie L.; Hocker, Michael Brian.

In: Respiratory Care, Vol. 59, No. 10, 01.10.2014, p. e149-e152.

Research output: Contribution to journalArticle

Cappiello, Jhaymie L. ; Hocker, Michael Brian. / Noninvasive ventilation in severe acute asthma. In: Respiratory Care. 2014 ; Vol. 59, No. 10. pp. e149-e152.
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