TY - JOUR
T1 - Isoflurane therapy for status asthmaticus in children
T2 - A case series and protocol
AU - Wheeler, Derek S.
AU - Clapp, Christopher R.
AU - Ponaman, Michael L.
AU - McEachren BSN, Heather
AU - Poss, Bradley W.
PY - 2000/7
Y1 - 2000/7
N2 - Objective:To describe the use of inhaled isoflurane by using a standardized protocol in the treatment of respiratory failure secondary to status asthmaticus in a series of pediatric patients. Design:Case series. Setting:Pediatric intensive care unit of a tertiary care military medical facility. Patients:Six pediatric patients ranging in age from 14 months to 15 yrs who were treated with isoflurane in our pediatric intensive care unit for status asthmaticus from 1995 to 1998. Intervention:Inhaled isoflurane therapy was initiated by using the treatment protocol after the patients had failed conventional medical management in the treatment of their asthma. Measurements and Main Results:All patients tolerated isoflurane therapy well by using our standardized protocol in conjunction with careful hemodynamic monitoring and support. The administration of inhaled isoflurane resulted in measurable improvements in the subject patients, as evidenced by statistically significant decreases in Paco2and peak inspiratory pressures, as well as a significant increase in pH. All six patients were successfully extubated and were discharged from the hospital without apparent sequelae. Conclusions:We conclude isoflurane may be a safe, effective treatment modality in the management of status asthmaticus refractory to aggressive medical therapy, although further study is warranted. We emphasize this mode of therapy should be instituted only after traditional treatment modalities have failed and appropriate intensive care support is available.
AB - Objective:To describe the use of inhaled isoflurane by using a standardized protocol in the treatment of respiratory failure secondary to status asthmaticus in a series of pediatric patients. Design:Case series. Setting:Pediatric intensive care unit of a tertiary care military medical facility. Patients:Six pediatric patients ranging in age from 14 months to 15 yrs who were treated with isoflurane in our pediatric intensive care unit for status asthmaticus from 1995 to 1998. Intervention:Inhaled isoflurane therapy was initiated by using the treatment protocol after the patients had failed conventional medical management in the treatment of their asthma. Measurements and Main Results:All patients tolerated isoflurane therapy well by using our standardized protocol in conjunction with careful hemodynamic monitoring and support. The administration of inhaled isoflurane resulted in measurable improvements in the subject patients, as evidenced by statistically significant decreases in Paco2and peak inspiratory pressures, as well as a significant increase in pH. All six patients were successfully extubated and were discharged from the hospital without apparent sequelae. Conclusions:We conclude isoflurane may be a safe, effective treatment modality in the management of status asthmaticus refractory to aggressive medical therapy, although further study is warranted. We emphasize this mode of therapy should be instituted only after traditional treatment modalities have failed and appropriate intensive care support is available.
KW - asthma
KW - inhalational anesthetics
KW - isoflurane
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U2 - 10.1097/00130478-200007000-00011
DO - 10.1097/00130478-200007000-00011
M3 - Article
C2 - 12813288
AN - SCOPUS:13444305278
SN - 1529-7535
VL - 1
SP - 55
EP - 59
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
IS - 1
ER -