Risk factors and outcome in Patients with severe acute asthma requiring mechanical ventilation

ABSTRACT

Severe acute asthma has been recognized as a cause of significant morbidity and mortality. Mechanical ventilation may be necessary to support life in the most critically ill patients. In this study, we set out to identify factors which may affect the outcome of management in severe acute asthma. Patients with severe acute asthma admitted to the intensive care unit of the Mubarak Al-Kabeer Hospital, Kuwait, over a 2-year period [1996 and 1997] were recruited for the study. The clinical features at presentation, drug treatment and the type of ventilation used, the duration of ventilation and the outcome were monitored. PaCO2, pH, and ventilation parameters were monitored. Thirty patients selected from a total of 36 patients admitted to the intensive care unit with diagnosis of severe acute asthma were studied. Twenty-one [70%] of these patients were mechanically ventilated. The duration of ventilation, and the duration in the intensive care unit for the patients who developed complications and for those who did not were found to be significant [p < 0.02 and p < 0.01, respectively]. There was no statistical difference in patients with or without complications in the following parameters at presentation pulse rate, respiratory rate, pH, PaCO2, duration of onset of symptoms, peak airway pressure, minute ventilation, tidal volume, and fraction of inspired oxygen. Two [9.5%] patients died. Factors found to affect outcome include duration of intubation, duration in intensive care unit and pulse rate at presentation. This study revealed that mechanical ventilation is effective and safe in management when it is critically applied and monitored