A CASE OF SEVERE ASTHMATIC ATTACK SUCCESSEFULLY TREATED BY ISOFLURANE INHALATION WITH PSV AND HFJV

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A 15-years old girl was admitted to our hospital with severe asthmatic attack. She failed to respond to intravenous administration of aminophylline, corticosteroid and isoproterenol. She was getting worse, and finally lost her consciousness, and then required controlled mechanical ventilation. Isoflurance inhalation (1.5%) was started with PSV and HFJV after CMV. Within an hour, high airway pressure with barotrauma decreased and clinical signs including arterial blood gas-analysis improved. Isoflurane inhalation was ceased on the 3rd hospital-day. She showed unevenful recovery, and was discharged from the hospital on the 47th hospital-day. We consider that isoflurane is a useful drug to treat status asthmatics because of the potent bronchodilation effect and the few adverse actions.Levels of LTB4 and LTC4 in bronchial lavage fluid on the first hospital day was increased, when compaired with those of the third hospital-day, indicating that LTs may play important roles for the development of the symptoms of bronchial asthma such as airway constriction and mucus secretion.
日本小児アレルギー学会の論文