NanoxāļĢāđāļēāļāļĒāļēāđāļāđāļŠāļ·āđāļ Social āļāļĒāđāļēāļāđāļĢ āđāļŦāđāđāļāđāļĒāļāļāļāļēāļĒâĶāļāļĒāđāļēāļāļĒāļąāđāļāļĒāļ·āļUtai Sukviwatsirikul
NanoxāļĢāđāļēāļāļĒāļēāđāļāđāļŠāļ·āđāļ Social āļāļĒāđāļēāļāđāļĢ āđāļŦāđāđāļāđāļĒāļāļāļāļēāļĒâĶāļāļĒāđāļēāļāļĒāļąāđāļāļĒāļ·āļUtai Sukviwatsirikul
11. 11
āļĄāļĩāļāļĨāļāđāļ§āļĒāđāļāļāļēāļĢāļĨāļāļāļēāļĢāļāļąāļāđāļŠāļāļāļāļāļŦāļĨāļāļāļĨāļĄ āļĨāļāļāļąāļāļĢāļēāļāļēāļĢāļāļāļāđāļĢāļāļāļĒāļēāļāļēāļĨ āđāļĨāļ°āļāļąāļāļĢāļēāļāļēāļĢāļāļĨāļąāļāļāđāļē āļāļ§āļĢāļāļīāļāļēāļĢāļāļēāđāļŦāđ
āđāļāļāļđāđāļāđāļ§āļĒāļŦāļ·āļāļāļēāđāļĢāļīāļāļāļąāļāļāļĨāļąāļāđāļāļāļāļļāļāļĢāļēāļĒ āļāļāļēāļāļĒāļēāļāļ·āļāļĢāļąāļāļāļĢāļ°āļāļēāļ prednsiolone 30-40 āļĄāļ. āļāļąāļāļāļĩ āļŦāļēāļ
āļĢāļąāļāļāļĢāļ°āļāļēāļāđāļāđāļŦāļĢāļ·āļāļāļĩāļ dexamethasone āļāļāļēāļ 4-10 āļĄāļ āļŦāļĢāļ·āļāđāļāļĩāļĒāļāđāļāđāļē āđāļĨāļ°āđāļŦāđāļāđāļāđāļāļ·āđāļāļāļĢāļēāļ§5-10 āļ§āļąāļ35,36,37
āļĒāļēāļāļ·āđāļāđ āļāļĩāđāđāļāđāđāļŠāļĢāļīāļĄāđāļāļāļēāļĢāļĢāļąāļāļĐāļē (adjunctive therapy)29
1 magnesium sulfate āļāļēāļĢāđāļŦāđāļĒāļēāđāļāļĢāļđāļāļāļĩāļ āļāļāļēāļ 2 āļāļĢāļąāļĄāđāļŦāđāļāļēāļāđāļŠāđāļāđāļĨāļ·āļāļāļāđāļēāđ āđāļ 15 āļāļēāļāļĩ āļāđāļ§āļĒāļĨāļāļāļąāļāļĢāļēāļāļāļ
āđāļĢāļāļāļĒāļēāļāļēāļĨāđāļāļāļđāđāļāđāļ§āļĒāļāļĩāđāļāļēāļāļēāļĢāļĢāļļāļāđāļĢāļ āļŠāđāļ§āļāļĒāļēāđāļāļĢāļđāļāļāđāļāđāļĄāđāļĄāļĩāļŦāļĨāļąāļāļāļēāļāļ§āđāļēāđāļāđāļāļĢāļ°āđāļĒāļāļāđ38
2 inhaled āļŦāļĢāļ·āļ nebulized corticosteroid āđāļāđāđāļāļāļđāđāļāđāļ§āļĒāļāļĩāđāļĄāļĩāļāļēāļāļēāļĢāļĢāļļāļāđāļĢāļ āđāļĨāļ°āđāļĨāļ·āļāļāđāļāđāđāļāļĢāļēāļĒāļāļĩāđāđāļĄāđ
āļāļāļāļŠāļāļāļāļāđāļāļĒāļēāļāļąāđāļ§āđāļ40
3 aminophylline āđāļĄāđāļĄāļĩāļŦāļĨāļąāļāļāļēāļāļŠāļāļąāļāļŠāļāļļāļāļĄāļēāļāļāļāļ§āđāļēāļāđāļ§āļĒāđāļŠāļĢāļīāļĄāļāļąāļ ïĒ agonist āđāļāļāļēāļĢāļĢāļąāļāļĐāļēāļāļđāđāļāđāļ§āļĒāļŦāļ·āļāļāļąāļāļāļĨāļąāļ
Agents Administration
Oxygen High flow to maintain SaO2 >92-95% (via nasal prong,
mask, ET) with humidification
ïĒ2-agonist MDI: Initial dose 4-8 puffs (salbutamol 100ïg /p) can be
repeated q 15-20 min up to 3 times
Wet NB: Initial dose 5-10 mg of salbutamol repeated q 15-
20 min
Systemic
Corticosteroid
Prednisolone 40 mg orally or methylprednisolone 125 mg IV
Anticholinergic
(ipatropium
bromide)
MDI dose 4-8 puff (20 mcg/puff) q 15-20 min to be repeated
3 times
Wet NB: initial 0.25-0.5 mg (1 ml in 3 ml saline) q 15-20
min or continuous
Magnesium sulfate Intravenous 2 gm bolus then infusion 25 mg/kg/hr
Inhaled
corticosteroid
Nebulized fluticasone 2 mg
āļāļēāļĢāļāļđāđāļĨāđāļāļāļĢāļāļĩāļāļĩāđāļĄāļĩāļĢāļ°āļāļāļāļēāļĢāļŦāļēāļĒāđāļāļĨāđāļĄāđāļŦāļĨāļ§
āļāđāļāļāđāļāļāļĩāđ āļāļ·āļāļāļđāđāļāđāļ§āļĒāļĄāļĩāļāļēāļāļēāļĢāļāļķāļĄ āđāļĄāđāļĢāļđāđāļŠāļķāļāļāļąāļ§ āļŦāļĢāļ·āļāļŦāļĒāļļāļāļŦāļēāļĒāđāļ āļāļīāļāļēāļĢāļāļēāđāļŠāđāļāđāļāļāđāļ§āļĒāļŦāļēāļĒāđāļ āđāļĨāļ°āļāđāļ§āļĒāļŦāļēāļĒāđāļāļāđāļ§āļĒ
āđāļāļĢāļ·āđāļāļāļāđāļ§āļĒāļŦāļēāļĒāđāļāļāļāļīāļ volume āļŦāļĢāļ·āļ pressure controlled ventilation āļāđāđāļāđ āļāļĒāļēāļĒāļēāļĄāļŦāļĨāļĩāļāđāļĨāļĩāđāļĒāļāļāļēāļĢāļāļąāđāļ
tidal volume āļāļĩāđāļŠāļđāļ āđāļĨāļ°āļĢāļ°āļ§āļąāļāļāļēāļĢāđāļāđāļĒāļēāļāļĨāļēāļĒāļāļĨāđāļēāļĄāđāļāļ·āđāļ āļĢāļ§āļĄāļāļąāđāļāļĢāļ°āļ§āļąāļāļāļēāļĢāđāļāļīāļāļ āļēāļ§āļ° barotrauma āđāļāļĒāļāļĒāļēāļĒāļēāļĄ
āļāļēāļāļąāļāđāļŦāđpeak airway pressure (PIP) āļāđāļēāļāļ§āđāļē 30 cmH2O āļŠāđāļ§āļ41
āđāļĄāđāđāļāļ°āļāļēāđāļŦāđāđāļāđnon invasive
positive pressure ventilation āđāļāļāļđāđāļāđāļ§āļĒāļŦāļ·āļāļāļąāļāļāļĨāļąāļāļāļąāđāļ§āđāđāļ āđāļāļ·āđāļāļāļāļēāļ āļŦāļĨāļąāļāļāļēāļāļŠāļāļąāļāļŠāļāļļāļāļĒāļąāļāđāļĄāđāļĄāļēāļāļāļ42
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