Mansel J K, Stogner S W, Petrini M F, Norman J R
Department of Medicine, University of Mississippi Medical Center, Jackson.
Am J Med. 1990 Jul;89(1):42-8. doi: 10.1016/0002-9343(90)90096-v.
Acute respiratory failure necessitating intubation and mechanical ventilation in patients with acute severe asthma is relatively uncommon, and there are few data available regarding positive pressure ventilation in critically ill patients with asthma. We therefore decided to evaluate our experience with the use of mechanical ventilation for acute asthma and to critically review previous reports on this subject.
A retrospective analysis of all medical records of patients who required mechanical ventilation for acute severe asthma was performed for the period of 1980 to 1988. Various clinical parameters were reviewed and examined via Fisher's exact test for association with survival.
Twenty-seven patients who underwent ventilation for a total of 32 episodes of mechanical ventilation comprised our study group. The overall mortality was 22%. A total of 76 complications were documented, including six episodes of barotrauma. The mean duration of artificial ventilation was 114 hours for nonsurvivors and 77 hours for survivors (p less than 0.05).
Although there appears to be a trend toward increased survival after mechanical ventilation for acute asthma, ventilation of critically ill asthmatic patients continues to be a potentially perilous venture associated with significant morbidity and mortality.
在急性重症哮喘患者中，需要插管和机械通气的急性呼吸衰竭相对少见，关于重症哮喘患者正压通气的可用数据很少。因此，我们决定评估我们使用机械通气治疗急性哮喘的经验，并严格审查以前关于该主题的报告。
对1980年至1988年期间因急性重症哮喘需要机械通气的所有患者的病历进行回顾性分析。通过Fisher精确检验对各种临床参数进行审查和检查，以确定其与生存的相关性。
27例接受通气治疗的患者共进行了32次机械通气，构成了我们的研究组。总体死亡率为22%。共记录了76例并发症，包括6例气压伤。非幸存者的人工通气平均持续时间为114小时，幸存者为77小时（p<0.05）。
尽管机械通气治疗急性哮喘后生存率似乎有上升趋势，但重症哮喘患者的通气仍然是一项潜在危险的操作，伴有显著的发病率和死亡率。
