Scoggin C H, Sahn S A, Petty T L
JAMA. 1977 Sep 12;238(11):1158-62.
A retrospective analysis of 811 patients admitted to the hospital for status asthmaticus over a nine-year period was performed. Eight patients died, and 19 required mechanical ventilation. All persons who died of status asthmaticus were in the group that required mechanical ventilation. In 12 of the patients who received ventilation, no definite cause for the acute exacerbation could be identified, although initial arterial blood gas analyses showed profound hypoxemia, hypercapnia, and acute respiratory acidosis. Seventy-eight major complications occurred during mechanical ventilation. Pneumothorax, endotracheal tube malfunction, alveolar hypoventilation on the ventilator, and pneumonia were associated with decreased survival. Mucous plugging of the airways was found in all autopsied patients. Mechanical ventilation in status asthmaticus is a life-support system associated with substantial morbidity and should be instituted only when it becomes evident that maximal medical therapy will not be efficacious.
对811例在9年期间因哮喘持续状态入院的患者进行了回顾性分析。8例死亡，19例需要机械通气。所有死于哮喘持续状态的患者均在需要机械通气的组中。在接受通气的12例患者中，尽管初始动脉血气分析显示严重低氧血症、高碳酸血症和急性呼吸性酸中毒，但无法确定急性加重的确切原因。机械通气期间发生了78例主要并发症。气胸、气管内插管故障、呼吸机上的肺泡通气不足和肺炎与生存率降低有关。在所有尸检患者中均发现气道黏液堵塞。哮喘持续状态的机械通气是一种与高发病率相关的生命支持系统，仅在明显最大程度的药物治疗无效时才应实施。
