[Mechanical ventilation in acute asthma crisis]

Abstract

Background and objectives: The II Brazilian Consensus Conference on Mechanical Ventilation was published in 2000. Knowledge on the field of mechanical ventilation evolved rapidly since then, with the publication of numerous clinical studies with potential impact on the ventilatory management of critically ill patients. Moreover, the evolving concept of evidence - based medicine determined the grading of clinical recommendations according to the methodological value of the studies on which they are based. This explicit approach has broadened the understanding and adoption of clinical recommendations. For these reasons, AMIB - Associação de Medicina Intensiva Brasileira and SBPT - Sociedade Brasileira de Pneumologia e Tisiologia - decided to update the recommendations of the II Brazilian Consensus. Mechanical ventilation in the asthma attack has been one of the updated topics. Describe the most important topics on the mechanical ventilation during the asthma attack and suggest the main therapeutic approaches.

Methods: Systematic review of the published literature and gradation of the studies in levels of evidence, using the key words "mechanical ventilation" and "asthma".

Results: We present recommendations on the ventilatory modes and settings to be adopted when ventilating a patient during an asthma attack, as well as the recommended monitoring. Alternative ventilation techniques are also presented.

Conclusions: Protective ventilatory strategies are recommended when ventilating a patient during a severe asthma attack.