The treatment of status asthmaticus in the intensive care unit: A narrative review

Asthma is a common chronic respiratory disease where exacerbations can be associated with significant morbidity, mortality, and economic burden. Severe asthma exacerbations (SAEs) represent life-threatening episodes of symptom burden that require intensive care treatment. While outpatient asthma management is well-established by major organizational guidelines, there are limited evidence-based recommendations for treatment of SAEs requiring intensive care. This narrative review synthesizes current literature regarding conventional inpatient asthma therapies, ventilation strategies, and emerging rescue modalities for management of SAEs, including inhaled anesthetics and veno-venous extracorporeal membrane oxygenation and discusses future areas of interest for research. Until more robust clinical data is available, intensivists should weigh the potential risks and benefits of more advanced rescue therapies and consider a multidisciplinary approach to determining those most likely to benefit from these interventions.