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Example text

Other recommended drugs include intravenously applied theophylline and glucocorticoids, both limited to a treatment period of only a few days. The target of drug therapy is the relief of severe bronchial obstruction, thereby improving ventilation and gas exchange [3, 4]. A complete presentation of emergency drugs is provided in chapter 2. Rationale and indication for mechanical ventilation Treatment with mechanical ventilation is performed in an attempt to correct the deteriorating gas exchange that is unresponsive to conservative measures.

2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, Updated 2004. National Institutes of Health Publication No. 02-3659. Bethesda, MD, National Institutes of Health, 2004. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease, Updated 2004. Bethesda, MD, National Heart, Lung and Blood Institute, 2004.

This is discussed in more detail in chapter 2. For a review, see Jain et al. [65]. Early tracheotomy must be considered in patients with potentially longer ventilation periods. The best timing of tracheotomy in patients requiring mechanical ventilation is unknown, but early tracheotomy (within 48 h after initiation of mechanical ventilation) seems to outweigh the risks of prolonged translaryngeal intubation [66]. The period of invasive ventilation should be kept as short as possible. If the underlying pathology has resolved, weaning attempts from invasive ventilation should be made.

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ACM. Issue of Comm. ACM Sept. 2003


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