Source: Medical Innovation

Asthma is a common disease and respiratory disease, and elderly patients with severe bronchial asthma to some extent as compared with ordinary diagnosis and treatment of asthma is difficult. And because the elderly body and respiratory organs function degeneration, and often associated with other underlying diseases, leading to poor prognosis of the disease. In recent years, the survey results show that the prevalence of asthma in the elderly is rising, a serious threat to the health of patients [2]. Clinical manifestations of elderly patients with severe bronchial asthma as recurrent episodes of wheezing, shortness of breath, chest tightness, patients may have a sense of suffocation, irritability, sweating, not supine, severe obscure consciousness, would endanger life [3]. In therapy, the need for multiple drug therapy with a variety of mechanical ventilation. I specifically discussed the emergency mechanical ventilation therapy and prognosis of elderly patients with severe bronchial asthma, are as follows.

Materials and Methods

1.1 General information: Select September 2011 - July 2013 in our hospital emergency treatment of elderly patients with 80 cases of severe bronchial asthma. Inclusion criteria: meet the diagnostic criteria for severe bronchial asthma; clinical manifestations of cough, expectoration, there may be dehydration, fever, cyanosis and other symptoms; aged ≥60 years; onset to admission time <24 h. In which 45 males and 35 females, aged 60 to 83 years, mean (67.25 ± 2.14) years, duration of 5 to 15 years, the average (8.5 2 ± 0.44) years; Severe stage: severe 50 cases, severe degree 20 cases , status asthmaticus 10 cases; average years of schooling (16.25 ± 4.11) years; smoking in 45 cases, 32 cases of alcoholism. Comorbidities (available both): 22 cases of hypertension, heart failure in 15 cases, 22 cases of diabetes, 8 cases of gastrointestinal disorders, electrolyte imbalance four cases, three cases of other diseases.

1.2 Treatment: Conventional emergency admission are infusion, correction of electrolyte disorders, oxygen inhalation, keep the airway open. Use of corticosteroids intravenously using drugs including hydrocortisone, dexamethasone, etc. symptoms after the change of oral prednisone or inhaled BDP aerosol maintenance therapy. In the use of hormones, while actively using salbutamol, terbutaline aerosol spray are 2 / time, 3 to 4 times / d. In mechanical ventilation, administration of noninvasive positive pressure face mask or nasal mask artificial mechanical ventilation. Suction pressure of 8 ~ 20 cm Hª­2O (1 cm Hª­2O = 0.098 kPa), expiratory pressure of 4 ~ 6 cm H2O, oxygen concentration of 30% oxygen concentration of 30% to 80%, respiratory rate 12 to 16 times / min. Positive given erythromycin plus 5% dextrose injection droplet injection 1.0 ~ 2.0 g.

1.3 OUTCOME MEASURES: The prognosis were observed, while in front ventilation, ventilation after 4 h and 24 h, ventilation blood pressure, heart rate and respiratory rate monitoring.

1.4 Statistical Methods: All patients after emergency intervention, they are cured and no deaths in patients.

2 Results

Through observation, rear vent at 24 h systolic blood pressure and respiratory rate was significantly lower than the ventilation after 4 h, compared to before the ventilation was significantly (P <0.05).

3 Discussion

Bronchial asthma is common worldwide within a chronic inflammatory airway disease, in patients with chronic bronchial inflammation and become swollen and narrow so that breathing is not smooth, a serious threat to the health of patients. Severe bronchial asthma is a serious hazard to human health, especially in elderly severe bronchial asthma, severe symptoms, the prognosis is poor. Investigation showed that elderly asthma prevalence rate of 2.6% and a quarter has not been diagnosed in time, both the original asthma for many years and into old age, but also in the old age of onset [4]. Serious harm asthma in the elderly should not be underestimated, even though asthma mortality rates have declined in recent years, but the elderly asthma mortality rates. In the intervention, standardized drug regimens is essential, including glucocorticoid drugs, salbutamol, terbutaline have bronchial smooth muscle relaxation, excitement respiratory center and respiratory muscles and anti-inflammatory and immunomodulatory effects [5]. Meanwhile salbutamol, terbutaline and other receptor agonists have bronchial smooth muscle relaxation, relieve asthmatic symptoms, which is more effective and reliable inhalation [6]. When should the ordinary medical therapy and treatment was given mechanical ventilation therapy, all patients in this group were given mechanical ventilation, ventilation parameters need to be adjusted according to blood gas analysis findings, additional allergens from more effective prevention of asthma approach. In this group, all patients after emergency intervention, are cured and no deaths in patients. After 4 h with ventilation, contrast difference was statistically significant at 24 h before the rear vent systolic blood pressure and respiratory rate was significantly lower than the ventilation (P <0.05). In short, the rational use of drugs and mechanical ventilation is to improve the diagnosis and treatment of elderly patients with severe bronchial asthma, key to successful treatment, thereby improving the prognosis.