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Inhaled isoflurane for life-threatening bronchospasm in children

 Seo Hee Yoon  ;  Yoon Hee Kim  ;  In Suk Sol  ;  Min Jung Kim  ;  Hyo Sun Kim  ;  Kyung Won Kim  ;  Myung Hyun Sohn  ;  Chuhl Joo Lyu 
 Pediatric Allergy Immunology and Pulmonology, Vol.31(2) : 110-115, 2018 
Journal Title
 Pediatric Allergy Immunology and Pulmonology 
Issue Date
In this study, we present 2 pediatric cases with different responses to inhaled isoflurane therapy for refractory life-threatening bronchospasm. Case 1, a 1-year-old boy with chronic lung disease of infancy was admitted with severe dyspnea and wheezing. Since he became unresponsive to conventional therapies, namely, nebulized albuterol and ipratropium bromide, intravenous corticosteroids, and magnesium with mechanical ventilation, inhalation of 1% isoflurane was initiated. After 2 h of isoflurane inhalation therapy, his respiratory acidosis resolved and he was successfully weaned. Case 2, a 5-year-old girl with bronchiolitis obliterans syndrome, following allogeneic peripheral stem cell transplantation for B cell acute lymphoblastic leukemia, was admitted after 1 day of sudden-onset dyspnea. Along with severe bronchospasm, her hypercapnia and high peak airway pressure did not improve with conventional therapies. Therefore, isoflurane was started at 1.5%, but discontinued within 1 h due to aggravation of hypercapnia. She was eventually placed on extracorporeal membrane oxygenation. These cases highlight that isoflurane inhalation could be lifesaving for those with refractory bronchospasm, but that it should be used carefully since the patient response can vary based on the underlying disease.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0002-5634-9709
Kim, Yoon Hee(김윤희) ORCID logo https://orcid.org/0000-0002-2149-8501
Kim, Hyo Sun(김효선)
Sol, In Suk(설인숙) ORCID logo https://orcid.org/0000-0003-2470-9682
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
Lyu, Chuhl Joo(유철주) ORCID logo https://orcid.org/0000-0001-7124-7818
Yoon, Seo Hee(윤서희) ORCID logo https://orcid.org/0000-0002-8361-9815
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