Near-Fatal Asthma

By Mark D. Siegel, MD, FCCP

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Mechanical Ventilation

Intubation and Mechanical Ventilation

Determining precisely when to intubate is a challenging but critical decision. Except for patients with obvious respiratory failure, it may be difficult to distinguish initially between those destined to respond to bronchodilators and those who will fail. Even patients who initially have respiratory acidosis may improve sufficiently to avoid intubation. Indications for intubation include progressive respiratory failure, altered mental status, and hemodynamic instability, regardless of the results of arterial blood gas testing.⁵

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