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Question :

Posted On : 02 Oct 2004

I have a 4 year old admitted at present in ICU on ventilator .Known case of bronchial asthma was admitted with a very bad attack of asthma with respiratory acidosis. He is on iv Hydrocortisone ,Iv Salbutamol infusion 4 mcg,kg,min , iv Terbutaline prn basis {when has desaturation secondary to bronchospasm},nebuliser Salbutamol two hourly to hourly , MDI Salmeterol 100 mcg bd,MDI inflammide 800 cg bd and he still goes for bronchospasm on and off usually secondary to secretion. What else can i do for him? He does not seem to be headign to the way of improvement. Will MGSO4 be helpful to reduce the bronchospam in him?

Expert Answer :

No expert answer available.

Answer Discussion :

D.Bhaskar

MGSO4 can be tried,iv methylprednisolone can be tried,treat infection,rule out pulmonary leakage.

20 years ago

sameh Elsayed Zaki

management of asthma is not confined only to the medications , you should determine first of all what are the factors excacerbating the attack , is his father a smoker ? are you used to clean your house in his prescence ? do you live in an industrial area ?
all these questions should be answered { and I wish by no }
the treatment is excellent but also I do recommend the use of adrenaline subcutaneuosly { or racimic inhalation form } in the acute attack without delaying till the use of the ventilator and dererioration of the case .
regarding to the use of the MgSO4 , some studies has been conducted to it but it was not recommended by the gina guidlines nor the north american clinic of pediatrics { but it is still a card in our hand that we may use }also you did not tell us about the respiratory function of your son this is very important to categorize him and give him the proper dose . I wish for your son to be in the best condition

20 years ago

pediatriconcall

Before trying Mag sulp, one can give a trial of aminophylline and see the response. Mag sulp may be useful in refractory cases of bronchial asthma.

20 years ago

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