Abstract
We mailed a questionnaire to 263 hospitals in Kanagawa Prefecture asking whether mechanical ventilation for severe asthma attack in children had been used in the past 3 years. Hospitals responding positively were sent a second questionnaire. When results from thesecond questionnaire were analyzed, it was found that out of 10 children so treated, 5 were classified as severe, 3 were moderate, and 1 was mild. (In one case, the degree of severity was not identi-fied.) Five were allergic, and the other 5 were nonallergic. It wasthe first hospitalization for 5 cases. Oxygen was not used in 2 cases prior to mechanical ventilation.
In our department, the annual number of children admitted for asthma attack has decreased by two thirds in the last 15 years. Oxygen use has increased to 80% following introduction of the pulse-oxymeter monitor for SPO2. Subcutaneous injection of epinephrine, although popular until 1985, has been replaced with continuous isoproterenol inhalation and use of systemic steroid. Wehave treated 11 asthma attack cases with mechanical ventilation during the past 15 years, although none occurred during the last 3 years.
In conclution, it seems to be possible to decrease the necessity for mechanical ventilation for asthma attack by active and timely treatment at an early stage of the attack.
