Inhaled volatile anesthetic gas for severe bronchospasm in the emergency department

Bronchospasm is caused by reversible constriction of the smooth muscles of the bronchial tree. This causes obstruction of the lower airways, which is commonly seen at the emergency department (ED) in patients with acute exacerbation of asthma or chronic obstructive pulmonary disease. Ventilation may be difficult in mechanically intubated patientswith severe bronchospasmdue to airflowlimitation, air trapping, and high airway resistance. The beneficial effects of volatile inhaled anesthetic gas had been reported due to its bronchodilation properties. In this case series, we would like to share our experience delivering inhaled volatile anesthetic gas via a conserving device for three patients with refractory bronchospasm at the ED. Inhaled anesthetic gas is safe, feasible and should be considered as an alternative rescue therapy for ventilated patients with severe lower airway obstruction. (c) 2023 Elsevier Inc. All rights reserved.

Automated summary

Bronchospasm is reversible constriction of bronchial tree smooth muscles, commonly seen in patients with acute exacerbation of asthma or chronic obstructive pulmonary disease. Ventilation may be difficult in mechanically intubated patients with severe bronchospasm due to airflow limitation. Inhaled volatile anesthetic gas has shown to have bronchodilation properties and can be considered as an alternative rescue therapy for ventilated patients with severe lower airway obstruction.