Status asthmaticus: a large MICU experience

Abstract

Objective: To review the management and outcome of patients admitted to the Medical Intensive Care Unit (MICU) with status asthmaticus. Design: Retrospective chart review of all patients admitted to the MICU of a New York City hospital with status asthmaticus during the 5-year period 1995-1999. Results: During the 5-year period, there were 88 MICU admissions for status asthmaticus; the records of 87 were available for retrospective review. The study group comprised 63 women (including three pregnant women) and 24 men, mean age of 45 years. Six patients underwent cardiopulmonary resuscitation prior to MICU admission. Mechanical ventilation was required in 87% of admissions. The approach to all intubated patients during this time period was permissive hypercapnia. Mortality was 2 (2%) patients, both of whom sustained a pre-hospital cardiopulmonary arrest. Median duration of mechanical ventilation was 3 days. Significant complications included barotrauma, hypotension, ventilator-associated pneumonia, anoxic encephalopathy, and myopathy. Conclusion: We report a large experience with patients admitted to the MICU for management of status asthmaticus. Despite the many complications associated with intensive care of status asthmaticus, the mortality was low and related to prehospital cardiopulmonary arrest