The investigation of isoflurane therapy for status asthmaticus patients]

Status asthmaticus is defined as an attack of bronchial asthma that resists conventional treatment and continues for more than 24 hours. We report here about patients with status asthmaticus who were successfully treated with isoflurane inhalation. Of the 19 patients who were transferred to the intensive care unit (ICU) and underwent mechanical ventilation from January 1996 to May 2001, eleven patients who were first treated by isoflurane inhalation were targeted in this study. Their improvement was assessed 6 and 24 hours after anesthesia compared with their condition before anesthesia. The tidal volume, pH, and PaCO2 improved within 6 hours after anesthesia. For the next step, among the patients who were transferred to the critical care center soon after an attack of bronchial asthma and underwent mechanical ventilation, 8 patients who were treated by isoflurane inhalation anesthesia (Group I) and another 4 patients who were not treated by isoflurane (Group NI) were compared to assess the usefulness of isoflurane inhalation therapy. The patients in Group I stayed in the ICU and underwent mechanical ventilation for a shorter period. These patients had hypotension and liver dysfunction after the inhalation anesthesia, but these symptoms were improved by decreasing the concentration of isoflurane. Isoflurane inhalation therapy seemed useful for intractable status asthmaticus, and earlier introduction of this therapy is expected to achieve a greater therapeutic effect.