Evidence map›Paper›PMID 40737011›Full record

Observational studyCritical care explorations2025

Characteristics and Outcomes of Patients Receiving Volatile Anesthetics in Near-Fatal Asthma: A Retrospective Observational Cohort Study.

Christopher Remmington, Luigi Camporota, Daniel Taylor, Angelo Sousa, Barnaby Sanderson, Guy Glover

Abstract readObservational Study
In one paragraph

Observational study in Critical care explorations, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Christopher RemmingtonDepartments of Pharmacy and Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.ORCID 0000-0001-5600-8368
Luigi CamporotaDepartments of Pharmacy and Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
Daniel TaylorDepartments of Pharmacy and Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
Angelo SousaDepartments of Pharmacy and Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
Barnaby SandersonDepartments of Pharmacy and Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
Guy GloverDepartments of Pharmacy and Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

IMPORTANCE AND

objectivesInhaled volatile anesthetics are employed as rescue therapy in near-fatal asthma, despite limited evidence. This study aims to describe the characteristics, management, and outcomes of mechanically ventilated adult patients with near-fatal asthma, stratified by the use of volatile anesthetic therapy.

designRetrospective single-center observational cohort study.

settingTertiary critical care and extracorporeal membrane oxygenation (ECMO) unit.

participantsAdults 16 years old or older receiving mechanical ventilation (MV) for greater than or equal to 24 hours and/or ECMO between January 2016 and August 2023 for near-fatal asthma. MAIN OUTCOMES AND MEASURES: We recorded demographics, disease severity tidal volumes, and ventilator settings, by treatment over the first 100 hours. Outcomes were duration of ECMO and MV, ICU length of stay, 90-day mortality, and adverse drug reaction.

resultsSixty-two patients were included (62.9% female), with a median (interquartile range [IQR]) age of 45 years (29-51 yr). Median (IQR) pH 7.13 (6.93-7.23), Paco2 12.9 kPa (8.7-16.2 kPa), and tidal volume 178 mL (50-300 mL). Most patients received IV bronchodilators and 32 (51.6%) required ECMO. Thirty-eight patients (61.3%) were treated with volatile anesthetics. Volatile patients had worse ventilation and blood gas parameters before treatment, more barotrauma, and were more likely to be receiving ECMO. Despite this, improvements in tidal volume occurred in the volatile group (mean increase, 204 mL [83.9%]; 95% CI, 110-298; p < 0.001). Median (IQR) duration of MV and ICU length of stay in volatile and no volatile patients were 10 days (8-16 d) vs. 5 days (3-10 d; p = 0.001) and 15 days (13-20 d) vs. 9 days (7-14 d; p = 0.001), respectively. ICU and 90-day mortality in volatile and no volatile patients were 5.3% vs. 4.2%. CONCLUSIONS AND RELEVANCE: The use of inhaled volatile anesthetics for near-fatal asthma, including during ECMO, appears to be feasible and safe, and with favorable clinical outcomes; however, no conclusions regarding efficacy can be directly inferred.

Indexed as

Anesthetics, InhalationAsthmaAdultExtracorporeal Membrane OxygenationFemaleHumansIntensive Care UnitsLength of StayMaleMiddle AgedRespiration, ArtificialRetrospective StudiesTidal VolumeTreatment OutcomeAnesthetics, InhalationasthmaIntensive Care Unitsmechanical ventilationstatus asthmaticusvolatile anesthesia

Identifiers

PMID40737011
PMCPMC12316345

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.