RESPIRATION AND THE AIRWAY Emergency treatment of status asthmaticus with enoximone

Editor’s key points † Enoximone is a phospodiesterase III inhibitor, primarily used in treatment of heart failure. † The author presents a case report of eight patients with status asthmaticus refractory to treatment. † Enoximone was effective in all these patients in reversing bronchospasm. † Enoximone may have a role in refractory status asthmaticus in preventing tracheal intubation and mechanical ventilation. This report describes the treatment of eight patients with status asthmaticus, six of whom were already maximally treated. They were consequently treated with enoximone, a selective phosphodiesterase III inhibitor, in their refractory phase. Bronchodilatation in these patients was immediate. No side-effects were observed. Enoximone appears to be a valuable addition to the treatment of status asthmaticus. I.V. administration bypasses inhalation incapability in severe asthma. It is likely to reduce or altogether prevent the need for resorting to secondary or tertiary high-tech therapy such as mechanical ventilation or anaesthetics, thus avoiding complications, as well as for transfers to specialized intensive care units. Not only do these aspects enable substantial cost savings, but they also may spare the patient a lot of anguish and a prolonged recovery.