tailieunhanh - Báo cáo y học: "Extracorporeal life support for status asthmaticus: the breath of life that’s often forgotten"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Extracorporeal life support for status asthmaticus: the breath of life that’s often forgotten. | Available online http content 13 2 136 Commentary Extracorporeal life support for status asthmaticus the breath of life that s often forgotten Nana Ekua Coleman and Heidi J Dalton Department of Critical Care Medicine Children s National Medical Center The George Washington University School of Medicine Washington dC 20010 USA Corresponding author Heidi J Dalton hdalton@ Published 28 April 2009 Critical Care 2009 13 136 doi cc7757 This article is online at http content 13 2 136 2009 BioMed Central Ltd See related research by Hebbar et al. http content 13 2 R29 Abstract Status asthmaticus continues to be significant cause of intensive care admission morbidity and mortality in pediatric populations. Furthermore despite improved outpatient management and broader use of controller medications patients with severe status asthmaticus account for a notable proportion of these admissions. There is variability in management and outcomes between institutions however early and aggressive management to avoid respiratory failure is paramount. In those patients who progress to develop severe respiratory failure extracorporeal life support ECLS can be a life-saving therapy. Here we briefly overview the use of ECLS for status asthmaticus as reported through the Extracorporeal Life Support Organization including the specific institutional experience at Children s Healthcare of Atlanta at Egleston and consider how earlier initiation of ECLS may benefit patients with severe status asthmaticus refractory to conventional medical therapy. The Extracorporeal Life Support Organization ELSO registry reports 64 uses of ECLS during the period from 1986 to 2007 including 13 patients from Children s Healthcare of Atlanta at Egleston as presented by Hebbar and coworkers 1 in their discussion of extracorporeal life support ECLS for refractory severe status asthmaticus SSA . Overall survival was 100 in the Egleston cohort and 92 in the remaining