A Case of Effective Superimposed HFO to IPPV for Severe Asthma Attack

A 65Y/O male was admitted with an acute exacerbation of severe bronchial asthma. (and complaining of dyspnea) On the day of admission, the patient was treated with aminophylline, steroids and antibiotics. During the following three days, there was a some improvement in symptoms except wheezing. On the fourth hospital days, he was brought to the ICU with cyanosis and unconsciousness. Arterial blood gases were PO227.4mmHg, PCO272.6mmHg and pH 72.9 with room air. He was intubated and mechanically Ventilated with a volumecycled ventilator (Newport E100A). On the day folloving admission to the ICU, blood gas analysis showed stable normal values, but three days later, the patient showed regression on laboratory examination. Mechanical ventilation was performed with a HFO (MERA) superimposed to a IPPV (Servo 900C) delivering a driving pressure 0.8kg/cm2 at frequency 12Hz/sec. The facility of mucous flow were enhaced markedly by HFO and the patient was extubated two days after. Our results show that HFO superimposed to IPPV may be useful in treatment for status asthmaticus.