Department of Intensive Care Medicine and.
Br J Anaesth. 2013 Dec;111(6):967-70. doi: 10.1093/bja/aet257. Epub 2013 Jul 24.
Asthma is a common disease in children and often develops early in life. This multicentre retrospective case series describe the use and effectiveness of sevoflurane inhalation therapy in a series of children with severe asthma in the paediatric intensive care unit (PICU).
Seven children ranging from 4 to 13 yr of age admitted to the PICU of two tertiary care hospitals in the Netherlands were included. They all were admitted with the diagnosis of severe asthma requiring invasive mechanical ventilation and were treated with sevoflurane inhalation therapy.
The median (range) Pco2 level at the start, after 2 h, and at the end of sevoflurane treatment were 14 (5.1-24.8), 9.8 (5.4-17.0), and 6.2 (4.5-11.4) kPa (P=0.05) while the median (range) pH was 7.02 (6.97-7.36), 7.18 (7.04-7.35), and 7.43 (7.15-7.47) kPa (P=0.01), respectively. The median (range) peak pressure values declined from 30 (23-56) to 20.4 (14-33) cm H2O (P=0.03). No severe adverse effects besides hypotension, with sufficient response to norepinephrine treatment, were seen.
Sevoflurane inhalation corrects high levels of Pco2 and provides clinical improvement in mechanically ventilated children with life-threatening asthma who fail to respond to conventional treatment.
哮喘是儿童常见疾病，通常在生命早期发生。这项多中心回顾性病例系列研究描述了七氟醚吸入疗法在荷兰两家三级保健医院儿科重症监护病房（PICU）一系列严重哮喘儿童中的应用和疗效。
纳入了 7 名年龄在 4 至 13 岁的儿童，他们均因诊断为严重哮喘需要有创机械通气而入住 PICU，并接受了七氟醚吸入治疗。
七氟醚治疗开始时、2 小时后和结束时的 Pco2 中位数（范围）分别为 14（5.1-24.8）、9.8（5.4-17.0）和 6.2（4.5-11.4）kPa（P=0.05），pH 中位数（范围）分别为 7.02（6.97-7.36）、7.18（7.04-7.35）和 7.43（7.15-7.47）kPa（P=0.01）。峰压中位数（范围）从 30（23-56）降至 20.4（14-33）cm H2O（P=0.03）。除了低血压外，未见严重不良反应，给予去甲肾上腺素治疗后反应充分。
七氟醚吸入可纠正高碳酸血症水平，并为常规治疗无效的危及生命的哮喘机械通气儿童提供临床改善。
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