Abstract
Acute severe asthma is characterized by a state of airway inflammation and increased bronchiolar smoothmuscle tone that leads to increased resistance to expiration and lung hyperinflation. Despite the better knowledge of its pathophysiology, the incidence and severity of asthma in the last twenty years is increased worldwide, although with significant age and geographic variation. As a result, the number of patients requiring more intensive medical therapy has also increased. In the most severe cases, often referred to as near-fatal asthma, the institution of mechanical ventilation may be required. Volatile anesthetics have bronchodilator effects on the bronchial smooth muscle. The use of inhalational anesthetic agents for treatment of severe status asthmaticus has been documented in case reports, case series and small uncontrolled studies. Their use may be considered in any mechanically ventilated patients whose severe bronchospasm failed to respond to maximal medical treatment. In the present review article, we aim to provide a brief description of the physio-pathological and clinical features of acute severe asthma, and of the principles of treatment, focusing our attention on the use of the inhalational anesthetics in severe patients requiring mechanical ventilation and not responding to conventional therapy.
Keywords: Status asthmaticus, near-fatal asthma, inhalational anesthetics, halothane, isoflurane, sevoflurane
Current Drug Targets
Title: Inhalational Anesthetics in Acute Severe Asthma
Volume: 10 Issue: 9
Author(s): R. Vaschetto, E. Bellotti, E. Turucz, C. Gregoretti, F. Della Corte and P. Navalesi
Affiliation:
Keywords: Status asthmaticus, near-fatal asthma, inhalational anesthetics, halothane, isoflurane, sevoflurane
Abstract: Acute severe asthma is characterized by a state of airway inflammation and increased bronchiolar smoothmuscle tone that leads to increased resistance to expiration and lung hyperinflation. Despite the better knowledge of its pathophysiology, the incidence and severity of asthma in the last twenty years is increased worldwide, although with significant age and geographic variation. As a result, the number of patients requiring more intensive medical therapy has also increased. In the most severe cases, often referred to as near-fatal asthma, the institution of mechanical ventilation may be required. Volatile anesthetics have bronchodilator effects on the bronchial smooth muscle. The use of inhalational anesthetic agents for treatment of severe status asthmaticus has been documented in case reports, case series and small uncontrolled studies. Their use may be considered in any mechanically ventilated patients whose severe bronchospasm failed to respond to maximal medical treatment. In the present review article, we aim to provide a brief description of the physio-pathological and clinical features of acute severe asthma, and of the principles of treatment, focusing our attention on the use of the inhalational anesthetics in severe patients requiring mechanical ventilation and not responding to conventional therapy.
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Cite this article as:
Vaschetto R., Bellotti E., Turucz E., Gregoretti C., Corte Della F. and Navalesi P., Inhalational Anesthetics in Acute Severe Asthma, Current Drug Targets 2009; 10 (9) . https://dx.doi.org/10.2174/138945009789108747
DOI https://dx.doi.org/10.2174/138945009789108747 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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