Department of Emergency and Critical Care, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
World J Emerg Med. 2011;2(2):154-6.
Few studies have reported the effects of early tracheotomy in acute severe asthmatic patients. We report two patients with acute severe asthma who were successfully treated with early tracheotomy.
The two patients with acute severe asthma were retrospectively reviewed. They had been treated at the Department of Emergency and Critical Care, Renji Hospital, Shanghai Jiaotong University School of Medicine.
They developed progressively hypercapnia and severe acidosis, and were not improved after conventional therapies. Early tracheotomy after mechanical ventilation decreased airway resistance and work of breathing, and corrected hypercapnia and acidosis. Adequate gas exchange was maintained after tracheotomy. The two patients were subsequently weaned from mechanical ventilation and discharged.
Early tracheotomy could be a valuable approach in certain patients with severe asthma.
鲜有研究报道急性重症哮喘患者行早期气管切开术的效果。我们报告了 2 例经早期气管切开术成功治疗的急性重症哮喘患者。
回顾性分析上海交通大学医学院附属仁济医院急诊危重病科收治的 2 例急性重症哮喘患者的临床资料。
2 例患者均出现进行性高碳酸血症和严重酸中毒，常规治疗后未见改善。机械通气后行早期气管切开术降低了气道阻力和呼吸功，纠正了高碳酸血症和酸中毒。气管切开术后维持了充分的气体交换。2 例患者随后成功脱机并出院。
对于某些重症哮喘患者，早期气管切开术可能是一种有价值的治疗方法。
