Hananel J I, Barbers R G
Division of Pulmonary and Critical Care Medicine, University of Southern California School of Medicine, Los Angeles 90033, USA.
Curr Opin Pulm Med. 1998 Jan;4(1):4-8. doi: 10.1097/00063198-199801000-00002.
The incidence and severity of asthma continue to increase despite advances in therapy. Two types of severe asthma exacerbations have been described: "sudden onset" and "slow onset." Beta-adrenergic agonists and corticosteroids are still the mainstay of therapy in the intensive care unit. Hypercapnic hypoventilation is advocated as a mode of mechanical ventilation to maintain oxygenation while minimizing barotrauma. Sedating and paralytic agents must be used with caution to prevent complications such as myopathy, which may occur with prolonged use of these agents. Future avenues of study could include the use of leukotriene and platelet-activating factor inhibitors. Asthma management guidelines should be practiced to prevent worsening of bronchospasm to the point of severe exacerbation.
尽管治疗方法有所进步，但哮喘的发病率和严重程度仍在持续上升。已描述了两种严重哮喘加重类型：“突发型”和“缓发型”。β-肾上腺素能激动剂和皮质类固醇仍然是重症监护病房治疗的主要手段。提倡采用高碳酸血症性通气不足作为机械通气模式，以维持氧合同时将气压伤降至最低。镇静剂和麻痹剂必须谨慎使用，以防止诸如肌病等并发症，这些并发症可能因长期使用这些药物而发生。未来的研究途径可能包括使用白三烯和血小板活化因子抑制剂。应遵循哮喘管理指南，以防止支气管痉挛恶化为严重加重。
