Erschienen in:
01.10.2006 | Correspondence
Comment on “Management of mechanical ventilation in acute severe asthma: practical aspect” by Oddo et al.
verfasst von:
Randolph P. Cole
Erschienen in:
Intensive Care Medicine
|
Ausgabe 10/2006
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Excerpt
Oddo et al. [
1] recently reviewed the use of mechanical ventilation in the patient with severe status asthmaticus. In their discussion the potentially deleterious use of external PEEP in this situation was emphasized, including the work of Tuxen [
2] showing the possibility of progressive increases in end-inspiratory and end-expiratory lung volume with applied external PEEP. The authors cite the study by McFadden et al. [
3] in patients with asthma and conclude that the key site of airflow obstruction in acute asthma is located in the central, noncollapsible airways so that flow limitation is not present, and that application of external PEEP is not beneficial. Yet, in the study quoted and in other papers using helium-oxygen gas mixtures to determine the site of airflow obstruction both large and small airway sites of flow limitation were identified in patients with asthma [
4]. …
