Pulmonary and Critical Care Section, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
J Intensive Care Med. 2010 Jan-Feb;25(1):3-15. doi: 10.1177/0885066609350866.
Asthma remains a troubling health problem despite the availability of effective treatment. A small but significant number of asthmatics experience life-threatening attacks culminating in intensive care unit admission. Standard treatment includes high dose systemic corticosteroids and inhaled bronchodilators. Patients with especially severe attacks may develop respiratory failure and need endotracheal intubation and mechanical ventilation. Severe airway obstruction may lead to dynamic hyperinflation and the possibility of hemodynamic collapse and barotrauma. Fortunately, most intubated asthmatics survive if physicians adhere to key management principles intended to avoid or minimize hyperinflation. The purpose of this review is to discuss the pathogenesis of life-threatening asthma and to provide practical guidance to promote rationale, safe, and effective management.
尽管有有效的治疗方法，哮喘仍然是一个令人困扰的健康问题。少数但有重要意义的哮喘患者会经历危及生命的发作，最终需要入住重症监护病房。标准治疗包括大剂量全身皮质类固醇和吸入性支气管扩张剂。发作特别严重的患者可能会出现呼吸衰竭，需要气管插管和机械通气。严重的气道阻塞可能导致动态过度充气，并有可能发生血流动力学崩溃和气压伤。幸运的是，如果医生遵守旨在避免或最小化过度充气的关键管理原则，大多数接受插管的哮喘患者都能存活。本文的目的是讨论危及生命的哮喘的发病机制，并提供实用的指导，以促进合理、安全和有效的管理。
