ObjectiveTo review the efficacy of pressure-support ventilation in the management of children with status asthmaticus requiring mechanical ventilation.DesignA case series.SettingA university hospital.SubjectsChildren requiring mechanical ventilation due to respiratory failure despite medical therapy during an episode of acute asthma.InterventionsMechanical ventilation with pressure-support ventilation.Measurements and Main ResultsRespiratory parameters (ventilatory settings, minute ventilation, respiratory rate, airway pressures) and blood gases were determined before, on initiation, and for 6 hrs after pressure-support ventilation. Spontaneous ventilation with an initial respiratory rate of 45 breaths/min (range 31 to 46) and an inspiration/expiration ratio (I/E) of 1:1.2 (range 1:1.1 to 1:2) was readily established in each patient. Arterial pH normalized (7.41, range 7.39 to 7.43) within 6 hrs (4.25, range 2 to 6) of the time at which ventilation was begun and the Paco2decreased (p < .02) to 44 torr (range 39 to 47) (5.9 kPa, range 5.2 to 6.3) during pressure-support ventilation.ConclusionPressure-support ventilation permitted patient-cycled spontaneous ventilation in children with asthma. The ability of patients to determine their own respiratory pattern and to maintain forced exhalation during pressure-support ventilation may have important advantages in children with severe asthma who require mechanical ventilation. (Crit Care Med 1996; 24:1603-1605)