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Acute severe asthma treated by mechanical ventilation: 10 years' experience from a district general hospital.
  1. A R Luksza,
  2. P Smith,
  3. J Coakley,
  4. I J Gordan,
  5. S T Atherton

    Abstract

    A retrospective study was made of patients requiring mechanical ventilation (intermittent positive pressure ventilation--IPPV) for acute severe asthma in a district general hospital during 1974-83. Thirty two patients required IPPV on 34 occasions. Complications included pneumothorax in six (18%) patients, chest infection in 12 (35%) patients, pulmonary collapse in three (9%) patients, hypotension at induction of IPPV in 12 (35%), and gastrointestinal bleeding in three (9%). Three (9%) patients died. Therapeutic bronchial lavage was performed in 19 patients. The procedure produced a rise in effective static compliance from a mean of 17 (SD 6) ml/cm H2O to 24 (9) ml/cm H2O at four hours. Bronchial lavage was associated with a significant excess of respiratory infections. A feature common to most patients was undertreatment before admission to hospital.

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