Intensive care of status asthmaticus. A 10-year experience

Abstract

Previous reports have disclosed a high morbidity and mortality in hospitalized asthmatics, especially those treated in the intensive care unit. Recently, it has been questioned whether the benefits of treating asthmatics in the intensive care unit outweigh the potential hazards. To address this issue, we examined the outcome of status asthmaticus in our medical intensive care unit between January 1, 1978, and December 31, 1987. Eighty episodes of status asthmaticus occurred in 64 patients. In 50 episodes, respiratory failure (PaCO2 greater than 50 mm Hg) was present. In half of these episodes, mechanical ventilation was avoided despite severe acidosis and hypercapnia; in the remainder mechanical ventilation was required as a lifesaving measure. Most patients improved rapidly and required only a short stay in the intensive care unit. There were no deaths and few complications. This was accomplished by close monitoring and repetitive blood gas analysis. We believe that the previous high complication rates and mortality associated with the hospital care of status asthmaticus can be avoided.