Severe bronchial asthma requiring ventilation. A review of 20 cases and advice on management.

The natural history and outcome of 20 asthmatics who required mechanical ventilation is reviewed. Seven of these patients died. The majority of the deaths could have been prevented if: (1) The patient had been followed-up in an asthma clinic and had been fully informed of the danger of an asthmatic attack. (2) The medical staff had been trained more fully in the evaluation and management of a severe asthma attack. Careful sequential assessment will enable timely transfer of patients with severe bronchial asthma to a unit experienced in their management.