Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 22 , ISSUE 10 ( 2018 ) > List of Articles


Refractory status asthmaticus: A case for unconventional therapies

Rohit Vohra

Keywords : Extracorporeal membrane oxygenation, isoflurane, status asthmaticus

Citation Information : Vohra R. Refractory status asthmaticus: A case for unconventional therapies. Indian J Crit Care Med 2018; 22 (10):749-752.

DOI: 10.4103/ijccm.IJCCM_191_18

License: CC BY-ND 3.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2018; The Author(s).


Status Asthmaticus is a common reason for Emergency Room visits in children. Most of the asthma flares are successfully managed by use of β agonist and steroids. If these therapies fail to halt the progression of asthma, a number of medical therapies may be used to treat it. However, the data supporting the use of these therapies are conflicting. We present successful use of Extracorporeal Membrane Oxygenation and isoflurane in a child with Refractory Status Asthmaticus.

PDF Share
  1. National Asthma Education and Prevention Program. Expert panel report 3 (EPR-3): Guidelines for the diagnosis and management of asthma-summary report 2007. J Allergy Clin Immunol 2007;120:S94-138.
  2. Afzal M, Tharratt RS. Mechanical ventilation in severe asthma. Clin Rev Allergy Immunol 2001;20:385-97.
  3. Masoli M, Fabian D, Holt S, Beasley R, Global Initiative for Asthma (GINA) Program. The global burden of asthma: Executive summary of the GINA Dissemination Committee Report. Allergy 2004;59:469-78.
  4. Moorman JE, Akinbami LJ, Bailey CM, Zahran HS, King ME, Johnson CA, et al. National surveillance of asthma: United States, 2001-2010. Vital Health Stat 3 2012;35:1-58.
  5. Tan KS, McFarlane LC, Lipworth BJ. Effects of oral and inhaled corticosteroid on lymphocyte beta2-adrenoceptor function in asthmatic patients. Br J Clin Pharmacol 1997;44:565-8.
  6. Wong JJ, Lee JH, Turner DA, Rehder KJ. A review of the use of adjunctive therapies in severe acute asthma exacerbation in critically ill children. Expert Rev Respir Med 2014;8:423-41.
  7. Char DS, Ibsen LM, Ramamoorthy C, Bratton SL. Volatile anesthetic rescue therapy in children with acute asthma: Innovative but costly or just costly?. Pediatr Crit Care Med 2013;14:343-50.
  8. Carrié S, Anderson TA. Volatile anesthetics for status asthmaticus in pediatric patients: A comprehensive review and case series. Paediatr Anaesth 2015;25:460-7.
  9. Turner DA, Heitz D, Cooper MK, Smith PB, Arnold JH, Bateman ST, et al. Isoflurane for life-threatening bronchospasm: A 15-year single-center experience. Respir Care 2012;57:1857-64.
  10. Tobias JD. Therapeutic applications and uses of inhalational anesthesia in the pediatric Intensive Care Unit. Pediatr Crit Care Med 2008;9:169-79.
  11. Rehder KJ. Adjunct therapies for refractory status asthmaticus in children. Respir Care 2017;62:849-65.
  12. Rehder KJ, Turner DA, Bonadonna D, Walczak RJ Jr., Cheifetz IM. State of the art: Strategies for extracorporeal membrane oxygenation in respiratory failure. Expert Rev Respir Med 2012;6:513-21.
  13. Hebbar KB, Petrillo-Albarano T, Coto-Puckett W, Heard M, Rycus PT, Fortenberry JD, et al. Experience with use of extracorporeal life support for severe refractory status asthmaticus in children. Crit Care 2009;13:R29.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.