Wetzel R C
Department of Anesthesiology/Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
Crit Care Med. 1996 Sep;24(9):1603-5. doi: 10.1097/00003246-199609000-00028.
To review the efficacy of pressure-support ventilation in the management of children with status asthmaticus requiring mechanical ventilation.
A case series.
A university hospital.
Children requiring mechanical ventilation due to respiratory failure despite medical therapy during an episode of acute asthma.
Mechanical ventilation with pressure-support ventilation.
Respiratory parameters (ventilatory settings, minute ventilation, respiratory rate, airway pressures) and blood gases were determined before, on initiation, and for 6 hrs after pressure-support ventilation. Spontaneous ventilation with an initial respiratory rate of 45 breaths/min (range 31 to 46) and an inspiration/expiration ratio (I/E) of 1:1.2 (range 1:1.1 to 1:2) was readily established in each patient. Arterial pH normalized (7.41, range 7.39 to 7.43) within 6 hrs (4.25, range 2 to 6) of the time at which ventilation was begun and the Paco2 decreased (p < .02) to 44 torr (range 39 to 47) (5.9 kPa, range 5.2 to 6.3) during pressure support ventilation.
Pressure-support ventilation permitted patient-cycled spontaneous ventilation in children with asthma. The ability of patients to determine their own respiratory pattern and to maintain forced exhalation during pressure-support ventilation may have important advantages in children with severe asthma who require mechanical ventilation.
