Abstract

Objectives:

To investigate the outcome of patients with status asth­maticus (SA) treated in a respiratory intensive care unit (RICU).

Design:

A retrospective study conducted in the RICU of a training hospital on 12 consecutive patients with SA admitted to RICU bet­ween March 2001-December 2003.

Results:

All cases were previously diagnosed and being followed up for 2-30 years. Female/male ratio was 11/1, mean age was 57± 12 yrs. Initial APACHE II score: 19±4 (11-27); pH: 7.21±0.95; PaCO2: 92± 18 mmHg; PaO2: 51 ± 17 mmHg. Out of 12 patients, 6 received NIMV (IPAP: 10± 1, EPAP 5±1 cmH2O) for 1-3 days (9±5hrs/day) with a success rate of 50%. A total of 9 cases underwent intubati­on. 1MV was administered initially with volume-controlled mode in all patients and subsequently it was switched to a pressure-cont­rolled mode in three cases because of the high airway and plateau pressures. The mean duration of the weaning period was 45 ±37 hrs and total duration of IMV was 123±82 hrs. Out of 9 patients, 7 we­re sent to the hospital ward with improvement. Two cases, one for a technical problem on the 2ni-l day and the other due to develop­ment of a cerebrovascular accident on the 14th day, were sent to another hospital. We were informed that both were discharged from that hospital in good condition.

Conclusion:

It is vital to have facilities for NIMV and IMV in every chest disease hospital for the management of life threatening events in asthmatics with severe attacks.