Source: Annual Congress 2010 - Acute respiratory failure
Disease area: Respiratory critical care

Abstract

This study have been conducted on 20 patients with acute sever asthma admitted in ICU in Chest & Anesthesia Departments, Faculty of Medicine, Tanta University, Egypt.
They were classified randomly into two groups: Group I: 10 patients, received ketamine as an induction agent and conventional mechanical ventilation in the form moderate tidal volume 8-10 ml/kg, respiratory rate 13-15 cycle/min., Group II: 10 patients received propofol as an induction agent and low stretch mechanical ventilation in the form of tidal volume 5-7 ml/kg, respiratory rate 9-11 cycle/min.
In this study, the duration of mechanical ventilation ranged between 3 to 11 days with significantly longer duration of mechanical ventilation in group I than group II.
Two patients in group I needed re-intubation after weaning from mechanical ventilation.
Peak airway pressure was found to be significantly higher in group I compared to group II, also plateau pressure was found to be significantly higher in group I compared to group II after 1hr, 3hrs, 6 hrs, 24 hrs and 36 hrs from intubation.
Arterial blood Gases: pH changes were found to be significantly lower in group II compared to group I and PaCO₂ changes were found to be significantly higher in group II compared to group I after 3hrs, 6 hrs, 24 hrs and 36 hrs from intubation. PaO₂ changes were found to be significantly lower in group I compared to group II after 6hs, 24hs and 36hs.
It is concluded that, in acute severe asthma, Ketamine is better than propofol as an induction agent. Low stretch mechanical ventilation has lower incidence of complications, shorter duration of mechanical ventilation and lower incidence of re-intubation after weaning.

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Citations should be made in the following way:
A. Farhat, H. Bahr, G. Attia, B. Nassar, A. El-Sheikh, W. El-Habashy (Tanta, Egypt). Conventional mechanical ventilation versus low stretch strategy in acute severe asthma. Eur Respir J 2010; 36: Suppl. 54, 2296

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