Asthma intubation provides a patient with a secure airway that can be used for mechanical ventilation in a severe asthma attack. This may be recommended for a patient who appears to be in acute respiratory distress. As the patient stabilizes, ventilator weaning can begin to reduce dependence on the ventilator and determine if the patient can breathe independently. The criteria for deciding when a patient should be intubated can depend on the policies at a facility, the patient’s history, and a medical professional’s experience with asthma care.
In the intubation process, a tube is inserted into the patient’s trachea to reach the airway. Patients with asthma can experience extreme swelling that makes it hard to breathe, which can cause asphyxia in extreme cases. Intubation keeps the airway open to allow the lungs to get oxygen. Other treatment options including medication and an oxygen mask may be considered first because of the potential complications associated with asthma intubation.
Several things can make a patient a good candidate for asthma intubation. One is signs of cardiac or respiratory failure, including indicators that the patient is about to go into cardiac or respiratory arrest. Another factor that can make asthma intubation a good choice may be extreme fatigue or altered level of consciousness which might make it difficult for the patient to understand and comply with treatment. Someone who is very agitated, for example, might pull off an oxygen mask or refuse treatment with nebulized medications to open the airway.
Another issue can be status asthmaticus, a rare and potentially serious kind of asthma attack that persists for hours in spite of treatment. This is more common in patients who have poorly controlled asthma, and it can become fatal if the patient doesn’t get prompt care. Patients experiencing this kind of acute exacerbation of asthma may need intubation and intensive care while they start to stabilize. Once the patient is feeling better, a long-term care plan can be developed.
Risks of asthma intubation can include airway injuries during the procedure, as well as infections caused by prolonged intubation. Patients can also experience complications when mechanical ventilation is withdrawn and the tube is removed, including low blood pressure and difficulty breathing on their own. Many hospitals have a specific protocol for extubation, the process where the patient’s tube is removed. This ensures that patients receive uniform care with standardized procedures for interventions and treatments if they develop complications during this process.
