Near fatal asthma in the emergency department: should intubate or not?

Abstract

Near-fatal asthma (NFA) is described as acute asthma associated with a respiratory arrest or arterial carbon dioxide tension greater than 50 mmHg, with or without altered consciousness, requiring mechanical ventilation. However, intubation and mechanical ventilation, in this category of asthmatic population, is a difficult managing task, especially in an emergency context. We reported the case of 23-year-old patient suffering from acute dyspnea presenting in our emergency department (ED) with a NFA associated to a respiratory peri arrest. Continuous nebulizers of bronchodilator therapy was successful with a good and rapid response to treatment. If intubation is an absolute indication for cardiac or respiratory arrest, it is based on clinical judgement and evolvement after aggressive and optimal therapy in NFA patients.