Extracorporeal Life Support (ECLS) may be necessary for the survival of a patient with severe asthma. With proper asthma management it should only be needed rarely.
Indications for ECLS - all of the following:
(1) severe asthma in the intensive care unit (ICU)
(2) one or more of the following:
(2a) severe hypercapnia (PaCO2 > 100 mm Hg)
(2b) severe hypoxemia
(2c) severe acidosis with arterial pH <= 7
(2d) shock
(3) refractory to optimum and maximum medical management including mechanical ventilation
Many patients only require 1 to 4 days of ECLS.
Disadvantages:
(1) Complications are relatively common.
(2) ECLS is expensive and labor-intensive.
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