1 Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA.
2 Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA.
J Intensive Care Med. 2017 Jul;32(6):400-404. doi: 10.1177/0885066617713169.
In severe cases of status asthmaticus, when conventional therapies fail, volatile anesthetic agents remain a therapeutic option. When delivered outside of the operating room setting, specialized delivery techniques are needed to ensure the safe and effective use of volatile anesthetic agents. We present a 16-year-old adolescent with status asthmaticus who required the therapeutic administration of the volatile anesthetic agent, sevoflurane, in the pediatric intensive care unit (PICU). Although initially effective in reducing bronchospasm, progressive hypercarbia developed due to defective functioning of the carbon dioxide absorber of the anesthesia machine. This failure occurred as the soda lime compartment filled with water accumulated from circuit humidification and continuous albuterol therapy. The role of volatile anesthetic agents in the treatment of status asthmaticus in the PICU is discussed, options for delivery outside of the operating room presented, and potential problems with delivery reviewed.
在严重的哮喘持续状态下，当常规治疗失败时，挥发性麻醉剂仍然是一种治疗选择。当在手术室环境之外使用时，需要专门的输送技术来确保挥发性麻醉剂的安全有效使用。我们介绍了一位 16 岁的青少年哮喘持续状态患者，他需要在儿科重症监护病房（PICU）使用挥发性麻醉剂七氟醚进行治疗。尽管最初有效减轻了支气管痉挛，但由于麻醉机的二氧化碳吸收器功能缺陷，逐渐出现高碳酸血症。这种故障是由于从回路加湿和持续沙丁胺醇治疗中积累的水使苏打石灰腔充满水而导致的。讨论了挥发性麻醉剂在 PICU 中治疗哮喘持续状态的作用，提出了在手术室之外输送的选择，并回顾了输送的潜在问题。
