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Management of acute life-threatening asthma exacerbations in the intensive care unit

Management of acute life-threatening asthma exacerbations in the intensive care unit
Management of acute life-threatening asthma exacerbations in the intensive care unit

Managing acute asthma exacerbations in critical care can be challenging and may lead to adverse outcomes. While standard management of an acute asthma exacerbation is well established in outpatient and emergency department settings, the management pathway for patients with life-threatening and near-fatal asthma still needs to be fully defined. The use of specific interventions such as intravenous ketamine, intravenous salbutamol, and intravenous methylxanthines, which are often used in combination to improve bronchodilation, remains a contentious issue. Additionally, although it is common in the intensive care unit setting, the use of non-invasive ventilation to avoid invasive mechanical ventilation needs further exploration. In this review, we aim to provide a comprehensive overview of the available treatments and the evidence for their use in intensive care. We highlight the ongoing need for multicentre trials to address clinical knowledge gaps and the development of intensive-care-based guidelines to provide an evidence-based approach to patient management.

asthma, intensive care, non-invasive ventilation, ventilation
2076-3417
Talbot, Thomas
992561d9-5198-40d3-91a3-0606d1c08c66
Roe, Thomas
cc2b4fda-b121-44a0-a4c0-32c3df49ffd3
Dushianthan, Ahilanandan
013692a2-cf26-4278-80bd-9d8fcdb17751
Talbot, Thomas
992561d9-5198-40d3-91a3-0606d1c08c66
Roe, Thomas
cc2b4fda-b121-44a0-a4c0-32c3df49ffd3
Dushianthan, Ahilanandan
013692a2-cf26-4278-80bd-9d8fcdb17751

Talbot, Thomas, Roe, Thomas and Dushianthan, Ahilanandan (2024) Management of acute life-threatening asthma exacerbations in the intensive care unit. Applied Sciences (Switzerland), 14 (2), [693]. (doi:10.3390/app14020693).

Record type: Review

Abstract

Managing acute asthma exacerbations in critical care can be challenging and may lead to adverse outcomes. While standard management of an acute asthma exacerbation is well established in outpatient and emergency department settings, the management pathway for patients with life-threatening and near-fatal asthma still needs to be fully defined. The use of specific interventions such as intravenous ketamine, intravenous salbutamol, and intravenous methylxanthines, which are often used in combination to improve bronchodilation, remains a contentious issue. Additionally, although it is common in the intensive care unit setting, the use of non-invasive ventilation to avoid invasive mechanical ventilation needs further exploration. In this review, we aim to provide a comprehensive overview of the available treatments and the evidence for their use in intensive care. We highlight the ongoing need for multicentre trials to address clinical knowledge gaps and the development of intensive-care-based guidelines to provide an evidence-based approach to patient management.

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applsci-14-00693-v2 - Version of Record
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More information

Accepted/In Press date: 11 January 2024
Published date: 13 January 2024
Keywords: asthma, intensive care, non-invasive ventilation, ventilation

Identifiers

Local EPrints ID: 493578
URI: http://eprints.soton.ac.uk/id/eprint/493578
ISSN: 2076-3417
PURE UUID: 121822b0-5ae4-415e-81b3-95494ed9209b
ORCID for Ahilanandan Dushianthan: ORCID iD orcid.org/0000-0002-0165-3359

Catalogue record

Date deposited: 06 Sep 2024 16:48
Last modified: 07 Sep 2024 01:56

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Contributors

Author: Thomas Talbot
Author: Thomas Roe
Author: Ahilanandan Dushianthan ORCID iD

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