Patients with acute severe asthma who required invasive mechanical ventilation had low rates of mortality, according to the results of a recent study published in the journal PLoS One.

Researchers retrospectively reviewed medical records of patients with acute severe asthma requiring invasive mechanical ventilation over a 10-year period. Rates of in-hospital mortality were evaluated and compared to that of patients with other types of respiratory distress.

Of the 81 patients with acute severe asthma who required invasive mechanical ventilation evaluated, in-hospital mortality was 15%. The only factor that was retrospectively determined to be independently associated with in-hospital mortality was cardiac arrest on day of admission. In patients with cardiac arrest on day of admission, the rate of in-hospital mortality was 69%, while in patients without cardiac arrest, the rate was only 4%. In addition, patients who died had higher scores for both Simplified Acute Physiology Score (SAPS) II and Sequential Organ Failure Assessment (SOFA) and higher creatinine and lactate levels, as well as lower blood pressure, pH, and bicarbonate (HCO3) on day of hospital admission.

“In view of these findings, patients with [acute severe asthma] who do not present a cardiac arrest on the day of admission should be given aggressive treatment, including salvage therapies like ECMO [extracorporeal membrane oxygenation]. However, other studies are needed to specify the precise indications and the selection of patients for such exception treatments,” the study authors concluded.


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Reference

Binachon A, Grateau A, Allou N, et al. Acute severe asthma requiring invasive mechanical ventilation in the era of modern resuscitation techniques: a 10-year bicentric retrospective study. PLoS One. Published online October 2, 2020. doi:10.1371/journal.pone.0240063