Extracorporeal Support in Adults With Status Asthmaticus

Status asthmaticus is refractory bronchospasm that can result in hypercarbia, altered mental status, respiratory failure, hypoxemia, and death. The care of patients with status asthmaticus often requires care in the ICU and, in rare circumstances, consideration of extracorporeal membrane oxygenation (ECMO) or extracorporeal CO₂ removal support. Compared with ARDS, status asthmaticus is a relatively rare indication for venovenous ECMO and, to our knowledge, its use has not been examined in prospective multicenter studies. As ECMO becomes more widely available, it may be valuable for providers to understand better its role in the management of status asthmaticus. In this edition of “How I Do It,” we provide a case example of life-threatening status asthmaticus to discuss unique considerations in the care of these patients with this complex disease.