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Anesth Analg 1986; 65:193-195
© 1986 International Anesthesia Research Society
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Status Asthmaticus Treated with Isoflurane and Enflurane

Samuel M. Parnass, MD, James M. Feld, MD, William H. Chamberlin, MD, and Laurence J. Segil, MD

Departments of Medicine and Anesthesiology, and the Multidisciplinary Intensive Care Unit, Michael Reese Hospital and Medical Center, University of Chicago, Pritzker School of Medicine, Chicago, Illinois.

Abstract

Severe bronchospasm that is refractory to aggressive medical therapy and that requires tracheal intubation and mechanical ventilation is rare, occurring in only about 2% of patients hospitalized for asthma (1). Indeed, tracheal intubation may even worsen bronchospasm, and mechanical ventilation in status asthmaticus is associated with substantial morbidity and mortality (1). Heavy sedation and paralysis with pancuronium bromide may facilitate mechanical ventilation (2), but have no direct bronchodilatory effects. Inhalational anesthetics have been used as broncho-dilators for many years. In particular, halothane has been recommended for asthmatics refractory to maximal medical therapy (3), but its use has been limited by the risk of life-threatening arrhythmias (4). There are, however, other inhalational anesthetics with bronchodilatory effects that are less arrhythmogenic (5).

We report three patients with status asthmaticus refractory to maximal medical therapy who continued to deteriorate after intubation and paralysis but responded dramatically to the use of isoflurane and enflurane.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1986 by the International Anesthesia Research Society.