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Intensive Care Medicine
Published in: Intensive Care Medicine 1/2007

01-01-2007 | Pediatric Correspondence

Peak pressures or plateau pressures in acute asthma

Authors: Ritesh Agarwal, Alok Nath

Published in: Intensive Care Medicine | Issue 1/2007

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Excerpt

Sir: We read with interest the article “Isoflurane therapy for severe refractory status asthmaticus in children” wherein the authors describe the use of inhaled isoflurane in a series of children with life-threatening asthma [1]. However, it was surprising to note that in the algorithm the authors used the peak inspiratory pressure rather than plateau pressure for titration of tidal volumes and as a surrogate for lung hyperinflation. Peak inspiratory pressure does not reflect peak alveolar pressure or the degree of overdistension of alveolar structures, as the high pressures are encountered largely by robust proximal airways. …
Literature
1.
Shankar V, Churchwell KB, Deshpande JK (2006) Isoflurane therapy for severe refractory status asthmaticus in children. Intensive Care Med 32:927–933PubMedCrossRef
2.
Marini JJ (1991) Monitoring the mechanics of the respiratory system. In: Tobin MJ (ed) Respiratory monitoring. Churchill Livingstone, New York, pp 163–196
3.
Mutlu GM, Factor P, Schwartz DE, Sznajder JI (2002) Severe status asthmaticus: management with permissive hypercapnia and inhalation anesthesia. Crit Care Med 30:477–480PubMedCrossRef
4.
Williams TJ, Tuxen DV, Scheinkestel CD, Czarny D, Bowes G (1992) Risk factors for morbidity in mechanically ventilated patients with acute severe asthma. Am Rev Respir Dis 146:607–615PubMed
5.
Hess DR, Kacmarek RM (2002) Asthma. In: Hess DR, Kacmarek RM (eds) Essentials of mechanical ventilation. McGraw-Hill, New Delhi, pp 196–204
6.
Oddo M, Feihl F, Schaller MD, Perret C (2006) Management of mechanical ventilation in acute severe asthma: practical aspects. Intensive Care Med 32:501–510PubMedCrossRef
Metadata
Title
Peak pressures or plateau pressures in acute asthma
Authors
Ritesh Agarwal
Alok Nath
Publication date
01-01-2007
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 1/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-006-0423-z

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