Children with Near-Fatal Asthma: The Use of Inhaled Volatile Anesthetics and Extracorporeal Membrane Oxygenation.
Chasity M CusterErika R O'NeilJanaki PaskaradevanBrian J RissmillerMaria C GazzaneoPublished in: Pediatric allergy, immunology, and pulmonology (2022)
Background and Purpose: The use of extracorporeal membrane oxygenation (ECMO) has been described for near-fatal asthma that continues to be refractory despite maximal medical therapy. Methods: Patients admitted to the pediatric intensive care unit at Texas Children's Hospital from 2012 to 2020 with the diagnosis of asthma who were supported on ECMO or isoflurane were included in the study. Patient demographics, medication usage, and complications were compared between the case group (ECMO, n = 12) and the control group (isoflurane only, n = 8). Results: All patients survived to discharge. ECMO patients received shorter durations of albuterol (12 versus 104 h, P = 0.0002) and terbutaline (13.3 versus 31.5 h, P = 0.0250). There were no differences in complication rates between the 2 groups. Conclusion: ECMO is a reasonable and safe support method for patients with near-fatal asthma and may lead to less bronchodilator medication exposure when compared with inhaled volatile anesthetic use.
Keyphrases
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- respiratory failure
- chronic obstructive pulmonary disease
- end stage renal disease
- intensive care unit
- mechanical ventilation
- lung function
- newly diagnosed
- ejection fraction
- healthcare
- peritoneal dialysis
- prognostic factors
- patient reported outcomes
- risk factors
- adverse drug
- blood pressure
- air pollution
- childhood cancer
- gas chromatography