Extracorporeal life support for status asthmaticus: the breath of life that's often forgotten

Status asthmaticus continues to be significant cause of intensive care admission, morbidity, and mortality in pediatric populations. Furthermore, despite improved outpatient management and broader use of controller medications, patients with severe status asthmaticus account for a notable proportion of these admissions. There is variability in management and outcomes between institutions; however, early and aggressive management to avoid respiratory failure is paramount. In those patients who progress to develop severe respiratory failure, extracorporeal life support (ECLS) can be a life-saving therapy. Here, we briefly overview the use of ECLS for status asthmaticus, as reported through the Extracorporeal Life Support Organization, including the specific institutional experience at Children's Healthcare of Atlanta at Egleston, and consider how earlier initiation of ECLS may benefit patients with severe status asthmaticus refractory to conventional medical therapy.