The last decade has seen important increases in the prevalence, severity, and mortality attributable to asthma. Accordingly, clinicians are increasingly called on to care for patients with acute, severe asthma. It is critical that clinicians caring for these patients recognize that although mechanical ventilation may be lifesaving, it also routinely introduces potentially life-threatening
... [Show full abstract] complications. The prevalence and severity of these complications have led to the concept that mechanical ventilation should be avoided as a primary goal of management. This article briefly reviews the pathophysiologic considerations that are operative in the adult patient with acute, severe asthma. In this context, we discuss the decision to initiate mechanical ventilation and propose a proactive ventilator management strategy directed at minimizing the attendant complications.
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