Adrenaline before Unconventional Therapy for Status Asthamaticus.

How to cite this article: Gohil JR. Adrenaline before Unconventional Therapy for Status Asthamaticus. Indian J Crit Care Med 2019; 23(10):492.

Sir,

Refractory Status Asthmaticus: A Case for Unconventional Therapies, article by Vohra R has mentioned survival of a child after using ECMO and isoflurane when other treatments were not effective.[1] History of food ingestion prior to onset of status is not mentioned as there are foods like dairy, nuts, seafood, eggs, and pollution and color, that may precipitate an acute episode.

In the treatment however, inj. adrenaline and inj. hydrocortisone were not used; although intravenous methylprednisolone (2 mg/kg) was used. Intramuscular adrenaline is having better absorption and quicker effects than subcutaneous route.[2] Ipratropium is an atropine like drug and leads to thickening of secretions and mucus plugging and have to be removed by bronchoscopy lavage.

Injections of adrenaline and hydrocortisone should be administered before resorting to ECMO and isoflurane.