Managing the mechanically ventilated status asthmaticus patient скачать в хорошем качестве

Managing the mechanically ventilated status asthmaticus patient

Managing severe asthma exacerbation or status asthmaticus can be challenging. As much as possible we should try to prevent intubation and mechanical ventilation in these patients. These patients are difficult to ventilate. Most of the time these patients die from Air trapping, Dynamic hyperinflation and cardiovascular collapse. If they are intubated, we should use a low respiratory rate, low tidal volume ventilation with increase inspiratory to expiratory ratio to give them adequate time to exhale fully and avoid air trapping and auto PEEP. Ketamine and propofol are ideal for sedation. continuous albuterol ipratropium nebulizations and parentral epinephrine/terbutaline can be life saving. The goal of ventilation should be avoiding dynamic hyperinflation not correcting the acidosis or the PaCO2. We should accept permissive hypercapnia. #How not to kill the asthmatic patient #SmartHospitalist #mechanically ventilating the asthmatic patient