Perrotin D, Boissinot E, Ginies G
Presse Med. 1986 Oct 18;15(36):1809-12.
Fifty-four episodes of hypercapnic status asthmaticus (Pa CO2 50 mmHg or more) were treated with intravenous theophylline (6 mg/kg over 30 minutes, then 1 mg/kg/hour), intravenous hydrocortisone hemisuccinate (1 g then 500 mg 4-hourly) rehydration and oxygen therapy at a sufficient rate to obtain a Pa O2 of 80 mmHg or more. As a rule, improvement was rapid with a significant decrease of mean Pa CO2 values from 61 +/- 14 to 44.5 +/- 11.5 mmHg (P less than 0.001) over 2 hours. In only 3 cases was mechanical ventilation necessary. An initially high Pa CO2 value is not an absolute indication of mechanical ventilation. This method remains exceptional and can be avoided in most patients by the emergency medical treatment outlined above.
对54例高碳酸血症性哮喘持续状态（动脉血二氧化碳分压[Pa CO2]达50mmHg或更高）患者采用静脉注射氨茶碱（30分钟内注射6mg/kg，随后每小时注射1mg/kg）、静脉注射半琥珀酸氢化可的松（先注射1g，随后每4小时注射500mg）、补液及以足够速率进行氧疗以使动脉血氧分压（Pa O2）达到80mmHg或更高的方法进行治疗。通常，病情改善迅速，2小时内平均Pa CO2值从61±14显著降至44.5±11.5mmHg（P<0.001）。仅3例患者需要机械通气。初始时较高的Pa CO2值并非机械通气的绝对指征。这种方法仍属例外情况，通过上述紧急医疗处理，大多数患者可以避免这种情况。
