Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-25T11:06:21.024Z Has data issue: false hasContentIssue false

External Chest Compression in the Management of Acute Severe Asthma—A Technique in Search of Evidence

Published online by Cambridge University Press:  28 June 2012

Malcolm M. Fisher*
Affiliation:
Head, Intensive Therapy Unit, Royal North Shore Hospital; Clinical Professor, Department of Anaesthesia, University of Sydney NSW, Australia
Anne P. Whaley
Affiliation:
Staff Specialist, Intensive Therapy Unit, Royal North Shore Hospital, Sydney NSW, Australia
Roger R. Pye
Affiliation:
Specialist in Intensive Care, Sydney Adventist Hospital, NSW, Australia
*
Intensive Therapy Unit, Royal North Shore Hospital, St Leonard's, NSW 2065 Australia, mfisher@med.usyd.edu.au

Abstract

Compelling anecdotal evidence exists for the potentially lifesaving benefits of mechanical external chest compression (MECC), but no published trials of the technique exist. The history and technique for MECC are discussed and illustrated by a case report. Although the technique is not discussed in the Resuscitation Guideline 2000, and the need for it within the intensive care unit has reduced, the use of MECC will have its greatest impact when initiated in the prehospital setting for patients suffering from severe, sudden-onset, asphyxic asthma.

Type
Special Invited Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Smolnikoff, VP: Total bronchospasm and lung massage. Anaesthesia 1960;15:40.CrossRefGoogle ScholarPubMed
2. Watts, JIM: Thoracic compression for asthma. Chest 1984;86:505.CrossRefGoogle ScholarPubMed
3. Van der Touw, T, Tully, A, Amis, T et al. : Cardiorespiratory consequenses of expiratory chest wall compression during mechanical ventilation and severe hyperinflation. Crit Care Med 1993;21: 19081914.CrossRefGoogle Scholar
4. Benatar, S: Fatal Asthma. N Engl J Med 1986;314:423428.CrossRefGoogle ScholarPubMed
5. Wassallen, J, Schaller, M, Feihl, F et al. : Sudden asphyxic asthma: A distinct entity? Am Rev Respir Dis 1990;142:108111.Google Scholar
6. Wobig, E, Rosen, P: Death from asthma: Rare but real. J Emerg Med 1996;14:233240.CrossRefGoogle ScholarPubMed
7. Eason, J, Taylor, D, Cottam, S et al. : Manual chest compression for total bronchospasm. Lancet 1991;337:366. Letter.CrossRefGoogle ScholarPubMed
8. Rosengarten, P, Tuven, D, Dziukas, L et al. : Circulatory arrest induced by intermittent positive pressure ventilation in a patient with severe asthma. Anaes and Int Care 1991;19:118121.Google Scholar
9. Van der Touw, T, Mudaliar, Y, Nayyar, V: Cardiorespiratory effects of manually compressing the rib cage during tidal expiration in mechanically ventilated patients recovering from acute severe asthma. Crit Care Med 1998;26:13611367.CrossRefGoogle ScholarPubMed
10. American Heart Association: Advanced challenges in resuscitation section 3c near fatal asthma. Resuscitation 2000;46:279283.Google Scholar
11. Fisher, M, Bowey, J, Ladd-Hudson, K: External chest compression in acute asthma: A preliminary study. Crit Care Med 1989;17:686.CrossRefGoogle ScholarPubMed