The use of non‐invasive ventilation for life‐threatening asthma attacks: Changes in the need for intubation

Murase, Kimihiko; Tomii, Keisuke; Chin, Kazuo; Tsuboi, Taijū; Sakurai, Ayako; Tachikawa, Ryo; Harada, Yuka; Takeshima, Yoshimi; Hayashi, Michio; Ishihara, Kyosuke

doi:10.1111/j.1440-1843.2010.01766.x

Cited by 53 publications

(34 citation statements)

References 38 publications

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“…A few uncontrolled studies and RCTs have compared NIV versus routine care in patients with acute asthma [55,56]. Uncontrolled studies have shown physiological improvements in selected patients, whereas the RCTs and a meta-analysis have not shown differences in clinically relevant outcomes when comparing NIV with usual care [57].…”

Section: Recommendationmentioning

confidence: 99%

Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure

et al. 2017

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Section: Recommendationmentioning

confidence: 99%

Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure

et al. 2017

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“…Only two of these patients required intubation, an IMV rate of 18 versus 2 % with NIPPV (p = 0.01). This study also demonstrated a decrease in hospital length of stay using NIPPV (10.8 vs. 4.1 days, p \ 0.01) [27].…”

Section: Non-invasive Positive Pressure Ventilationmentioning

confidence: 92%

Controversies in the Care of the Acute Asthmatic in the Prehospital and Emergency Department Environments

Tennyson

2015

Curr Emerg Hosp Med Rep

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Asthma is an episodic disease of the airways characterized by inflammation and constriction of the bronchi. It has a significant societal impact with over 25 million persons affected in the United States alone and annually accounts for approximately 3300 deaths in the US. Standard therapy for acute severe asthma is effective for most patients, but controversies exist surrounding the care of the impending or actual respiratory failure patient. Non-invasive positive pressure ventilation has been effective in multiple case reports, but lacks large trial evidence to support its use. Intravenous ketamine similarly has supporting case reports, but an absence of rigorous evidence. Finally, parenteral beta-adrenergic medications have a long history of use, but have not been consistently shown to be superior to inhaled short-acting beta agonists. Further, they have been associated with higher rates of adverse effects.

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“…The authors also stated that a cautious trial of NIV may be applied in a severe asthma attack. 8 A retrospective cohort study by Murase et al 9 in 2010 of severe asthma treated with NIV reported a trend toward a decrease in intubation rates and concluded that the ready availability of NIV enables the rapid commencement of mechanical ventilation and may decrease the need for tracheal intubation. Also in 2010, Gupta et al 10 reported that adding NIV for this population may accelerate improvement in lung function, decrease inhaled bronchodilator requirement, and shorten ICU and hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Ventilation in Severe Acute Asthma

Cappiello

Hocker

2014

Respir Care

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Noninvasive ventilation (NIV) in severe acute asthma is controversial but may benefit this population by preventing intubation. We report on a 35-year-old male asthma patient who presented to our emergency department via emergency medical services. The patient was responsive, diaphoretic, and breathing at 35 breaths/min on 100% oxygen with bag-mask assistance, with S pO 2 88%, heart rate 110 -120 beats/min, blood pressure 220/110 mm Hg, and temperature 35.8°C. NIV at 12/5 cm H 2 O and F IO 2 0.40 was applied, and albuterol at 40 mg/h was initiated. Admission arterial blood gas revealed a pH of 6.95, P aCO 2 126 mm Hg, and P aO 2 316 mm Hg. After 90 min of therapy, P aCO 2 was 63 mm Hg. Improvement continued, and NIV was stopped 4 h following presentation. NIV tolerance was supported with low doses of lorazepam. The patient was transferred to the ICU, moved to general care the next morning, and discharged 3 days later. We attribute our success to close monitoring in a critical care setting and the titration of lorazepam.

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The use of non‐invasive ventilation for life‐threatening asthma attacks: Changes in the need for intubation

Cited by 53 publications

References 38 publications

Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure

Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure

Controversies in the Care of the Acute Asthmatic in the Prehospital and Emergency Department Environments

Noninvasive Ventilation in Severe Acute Asthma

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