A 50-year-old male is being managed for a severe asthma exacerbation. He has received salbutamol, ipratropium, IV magnesium, and IV hydrocortisone. He...

Question

A 50-year-old male is being managed for a severe asthma exacerbation. He has received salbutamol, ipratropium, IV magnesium, and IV hydrocortisone. He remains severely dyspnoeic with a rising EtCO2. The decision is made to perform RSI. What specific ventilation strategy should be used after intubation to minimise the risk of dynamic hyperinflation?

Accepted Answer

Low respiratory rate (8-10 breaths/min), long expiratory time (I:E ratio 1:3 or 1:4), moderate tidal volumes (6-8 mL/kg), and accepting permissive hypercapnia

Answer

Inspiratory-hold ventilation to maximise gas exchange

Answer

Standard ventilation settings - no modification is needed for asthma

Answer

High respiratory rate (20 breaths/min) to wash out CO2 quickly

Answer

Large tidal volumes (12 mL/kg) to overcome airway obstruction

uk-dipimc MCQ (SBA): Ventilation Strategy in Asthma