La ventilation mécanique dans l'asthme aigu grave

Many patients admitted to the intensive care unit, with severe asthma, simply require additional time for the therapies to be continued and for respiratory function to improve. A few patients will require positive pressure ventilatory support because of progression to respiratory failure in advance of response to treatment or prior to treatment. Mechanical ventilation of patients with severe asthma is fraught with difficulties. The aim of mechanical ventilation is to maintain adequate oxygenation and prevent respiratory arrest without circulatory compromise or lung injury until response to bronchodilatators permits ventilatory assistance to be withdrawn. A strategy of mechanical ventilation that aims to reduce dynamic hyperinflation will result in the best outcomes. Permissive hypercapnia, increase in expiratory time, small tidal volume are the mainstain in mechanical ventilation of status asthmaticus. Close monitoring of the patient's condition is necessary to obviate complications and to identify the appropriate time for weaning.