Status asthmaticus in the medical intensive care unit: A 30-year experience

Peters, Jay I.; Stupka, J; Singh, Harjinder; Rossrucker, Jill; Angel, Luis F.; Melo, Jairo; Levine, Stephanie M.

doi:10.1016/j.rmed.2011.11.015

Cited by 36 publications

(32 citation statements)

References 20 publications

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“…pulse rate and oxygen 40% of our status asthmaticus patients needed hospital admission. This number is lower than what has been reported by Peter et al 9 In that study, the admission rate was over 80%, however that was an ICU-based study. In TUH, there is limited access to beds in the general ward and ICU; therefore, patients must be treated over several hours, median of 11 h, in the ED, and this accounts for our relatively low admission rate.…”

Section: Discussioncontrasting

confidence: 65%

Characteristics and outcomes of treatment in status asthmaticus patients at emergency department

Amnuaypattanapon

Limjindaporn

Srivilaithon

et al. 2018

Asian Pac J Allergy Immunol

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Section: Discussioncontrasting

confidence: 65%

Characteristics and outcomes of treatment in status asthmaticus patients at emergency department

Amnuaypattanapon

Limjindaporn

Srivilaithon

et al. 2018

Asian Pac J Allergy Immunol

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“…This mortality rate may not be representative of status asthmaticus mortality rates in the United States. However, Peters et al 7 performed a retrospective observational study over a 30-y period to evaluate status asthmaticus subjects admitted to their medical ICU, and 61% of 227 subjects required intubation due to asthma exacerbation, although mortality was Ͻ 1%.…”

Section: See the Related Editorial On Page 756mentioning

confidence: 99%

A Comparison of Metered-Dose Inhaled Albuterol Versus Endotracheal Liquid Bolus Albuterol for the Treatment of Bronchoconstriction

2015

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INTRODUCTION:Aerosolized albuterol delivery is a mainstay treatment for bronchoconstriction; however, almost no data exist that evaluate the clinical outcome of instillation of an endotracheal liquid bolus (ELB) of a bronchodilator directly into the airway. METHODS: This randomized trial sought to evaluate the efficacy of albuterol lavage via artificial airway with accompanied patient positioning. Subjects receiving mechanical ventilation for acute respiratory failure with clinical manifestations of bronchoconstriction were assigned to initially receive either traditional albuterol via metered-dose inhaler (MDI) or albuterol via ELB lavage with follow-up administration of the other therapy after a 4-h washout period. Clinical data were collected at baseline and at 5 and 30 min post-treatment. RESULTS: Fourteen subjects (5 males, 9 females; mean age of 57.5 y) were included in this study. In the group receiving initial ELB, peak airway pressure decreased significantly (P ‫؍‬ .02), and a significant decrease in airway resistance mean scores was seen from baseline to 30 min post-treatment (P < .001) and from 5 to 30 min post-treatment (P ‫؍‬ .003), with no significant effects seen with follow-up MDI. In the initial MDI treatment group, no significant effect on peak airway pressure or airway resistance was noted. S pO 2 increased at 5 min post-treatment with ELB. In contrast, S pO 2 decreased 30 min post-treatment with MDI. Mean arterial pressure decreased post-treatment with ELB. The pattern in heart rate change post-treatment with ELB was similar to that post-treatment with MDI, with a significant increase at the 5-min interval from baseline (P < .01), followed by a significant decrease at the 30-min interval (P < .001). There were no differences in dynamic compliance at each time interval following administration of both the MDI (P ‫؍‬ .92) and ELB conditions (P ‫؍‬ .18). CONCLUSIONS: ELB albuterol lavage may be a viable option to reverse bronchoconstriction in intubated patients with limited response to traditional aerosolized albuterol via MDI. Key words: albuterol liquid bolus; albuterol lavage; novel use albuterol. [Respir Care 2015;60(5):627-635.

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“…Esophageal rupture 43 Iatrogenic-lung biopsy, pleural biopsy, or fine-needle biopsy; mechanical ventilation; thoracotomy; placement of subclavian vein catheter, chemotherapy [44][45][46][47][48][49][50] Primary lung diseases Asthma 51 Respiratory bronchiolitis 21 Cystic fibrosis 52,53 Usual interstitial pneumonia 54 Pulmonary infarction 55,56 Hypersensitivity pneumonitis [34][35][36]57 Infections Spontaneous pneumothorax usually occurs in young, thin men, particularly smokers, who have no obvious underlying lung diseases. In these patients, pneumothorax is presumed to result from rupture of bullae and blebs.…”

Section: Specific Findingsmentioning

confidence: 99%

Approach to Lung Biopsies From Patients With Pneumothorax

Schneider

Murali

Veraldi

et al. 2014

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Patients with pneumothorax occasionally require limited lung resections to control persistent air leaks. In some patients, especially smokers, histopathologic findings suggest that a ruptured bulla or bleb caused the pneumothorax. Other patients only exhibit histopathologic changes related to the physical trauma of acute, and likely occult recurrent, peripheral lung injury in the setting of “spontaneous,” or idiopathic, lung rupture. Sometimes, pneumothorax occurs secondary to an underlying localized or diffuse parenchymal lung disease. A comprehensive description of the morphologic findings that may be seen in these specimens will help the surgical pathologist distinguish patients with more common and indolent occurrences of pneumothorax from those requiring additional workup or treatment. Objective.—To develop a diagnostic approach for surgical pathologists encountering lung specimens obtained in the context of pneumothorax repair. Data Sources.—Literature review and consultation experience of the authors. Conclusions.—Two general categories of histopathologic changes can be identified: (1) nonspecific changes, reflecting the lung's acute and chronic response to localized injury, and (2) changes suggesting an underlying lung disease that may have played an etiologic role in the development of pneumothorax. The latter changes are important to recognize because they may require additional workup or treatment of clinically occult lung disease. Difficulty arises when nonspecific histopathologic changes overlap with those of an underlying lung disease. Awareness of these diagnostic challenges and pitfalls, together with clinicoradiographic correlation, is essential in these situations and will help guide the surgical pathologist toward an accurate diagnosis and the appropriate management of clinically occult disease.

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Status asthmaticus in the medical intensive care unit: A 30-year experience

Cited by 36 publications

References 20 publications

Characteristics and outcomes of treatment in status asthmaticus patients at emergency department

Characteristics and outcomes of treatment in status asthmaticus patients at emergency department

A Comparison of Metered-Dose Inhaled Albuterol Versus Endotracheal Liquid Bolus Albuterol for the Treatment of Bronchoconstriction

Approach to Lung Biopsies From Patients With Pneumothorax

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