SCCM Resource Library-Pediatric Near-Fatal Asthma: The Known and the Unknown

Video Transcription

Video Summary

The video discussed the use of extracorporeal life support (ECLS) as a rescue therapy for pediatric near-fatal asthma. The speaker highlighted that near-fatal asthma is a rare condition that occurs when conventional therapies fail to control severe acute asthma and patients become refractory to treatment. In these cases, ECLS, such as extracorporeal membrane oxygenation (ECMO) or extracorporeal carbon dioxide removal (ECOR), can be employed to provide temporary support for the heart and lungs. The speaker also discussed other adjunctive therapies for near-fatal asthma, including the use of magnesium, ipratropium, terbutaline, and aminophylline. Magnesium has been shown to reduce hospitalization rates in children who are non-responsive to conventional therapy. Ipratropium can be used in the emergency department to lower severity scoring, but its use in the ICU is limited. Terbutaline and aminophylline, which are beta agonists, have mixed evidence of effectiveness and can have adverse effects. The speaker concluded by emphasizing the need for further research to determine the efficacy, timing, and optimal mode of deployment for ECLS and adjunctive therapies for near-fatal asthma.

Asset Subtitle

Pediatrics, Pulmonary, 2021

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2021 Critical Care Congress held virtually from January 31-February 12, 2021.

Learning Objectives

Review indications and outcomes for patients who require extracorporeal membrane oxygenation support for near-fatal asthma
Review evidence and outcome data for the use of various anesthesia gases as well as nitric oxide and heliox as adjunctive therapies for near-fatal asthma
Discuss data and recommendations supporting the use of second-line therapies for near-fatal asthma including magnesium, aminophylline, terbutaline, and ipratropium bromide

Using ECMO to Rescue the Patient With Near-Fatal Asthma
Melania Bembea

Jumping to the Second Line
Sana Said

Meta Tag

Content Type Presentation

Knowledge Area Pediatrics

Knowledge Area Pulmonary

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Tag Asthma

Tag Respiratory Failure

Year 2021

Keywords

extracorporeal life support

pediatric near-fatal asthma

magnesium

ipratropium

terbutaline

aminophylline

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