Life-saving Inhaled Sevoflurane Administered to an Adult With Severe Bronchospasm Secondary to COPD Exacerbation

We present the case of a 60-year-old man who was admitted with severe COPD exacerbation, with critical bronchospasm that required mechanical ventilation after failed conventional therapies. This patient received oxygen, inhaled β-agonists and anticholingerics, intravenous corticosteroids, and macrolide antibiotics. He then required mechanical ventilation with administration of magnesium, ketamine, and inhaled heliox for his bronchospasm, with no improvement. Ultimately, he was treated successfully with an inhaled anesthetic, sevoflurane, as salvage therapy. Success was measured by decreasing peak and plateau airway pressures and a decreasing partial pressure of carbon dioxide during the administration of sevoflurane. Our case suggests an important and potential life-saving application for sevoflurane in the setting of an adult with severe bronchospasm, and larger investigations should be established to assess its role as a mainstay in rescue therapy.
Source: Clinical Pulmonary Medicine - Category: Respiratory Medicine Tags: Obstructive Airways Disease Source Type: research