Status asthmaticus complicated by atelectasis in a child

A case of an 11-year-old boy who was admitted for severe status asthmaticus complicated by extensive atelectasis is reported. Atelectasis involved all left lobes and the right upper lobe of the lung. Although the patient was refractory to maximal medical therapy and continued to deteriorate after intubation, he responded dramatically to the administration of isoflurane. Atelectasis was reduced immediately after fiberoptic bronchial lavage and the use of high frequency ventilation, with a marked improvement in blood gases. Isoflurane provided sedation during prolonged mechanical ventilation without significant adverse effects, aiding the care of this pediatric patient who ultimately recovered.