Manasrah Nouraldeen, Abdelazeem Basel, Al Qasem Sarah, Kandah Emad, Chaudhary Ahmed Jamal
Internal Medicine, Detroit Medical Center (DMC) Sinai Grace Hospital, Detroit, USA.
Internal Medicine, McLaren Health Care/Michigan State University (MSU), Flint, USA.
Cureus. 2021 Dec 2;13(12):e20117. doi: 10.7759/cureus.20117. eCollection 2021 Dec.
Near-fatal asthma (NFA) is a life-threatening condition that represents the most severe clinical phenotype of asthma and can progress to fatal asthma. Patients with NFA do not respond adequately to conventional medical therapy and urgent intervention is needed to provide adequate oxygenation by invasive mechanical ventilation. While mechanical ventilation is a potentially life-saving intervention, it could cause lung injury, barotrauma, and dynamic hyperinflation due to high ventilator settings resulting in hemodynamic instability. Extracorporeal membrane oxygenation (ECMO) provides full respiratory support with adequate gas exchange in patients with NFA and improves survival rate. We present a case of a young female patient who presented with NFA, and her clinical condition was worsening despite invasive positive pressure mechanical ventilation.
近致死性哮喘(NFA)是一种危及生命的疾病,代表哮喘最严重的临床表型,可进展为致死性哮喘。NFA患者对传统药物治疗反应不佳,需要紧急干预以通过有创机械通气提供足够的氧合。虽然机械通气是一种潜在的挽救生命的干预措施,但由于高通气设置导致血流动力学不稳定,它可能会导致肺损伤、气压伤和动态肺过度充气。体外膜肺氧合(ECMO)为NFA患者提供充分的呼吸支持和充足的气体交换,并提高生存率。我们报告一例年轻女性NFA患者,尽管进行了有创正压机械通气,但其临床状况仍在恶化。