Objective To evaluate the quality of available evidence to establish guidelines for
the use of noninvasive ventilation for the management of status asthmaticus
in children unresponsive to standard treatment.Methods Search, selection and analysis of all original articles on asthma and
noninvasive ventilation in children, published until September 1, 2014 in
all languages in the electronic databases PubMed, Web of Science, Cochrane
Library, Scopus and SciELO, located using the search terms: "asthma",
"status asthmaticus", "noninvasive ventilation", "Bronchospasm", "continuous
positive airway pressure", "child", "infant", "pediatrics", "hypercapnia",
"respiratory failure" and the keywords "BIPAP", "CPAP", "Bilevel", "acute
asthma" and "near fatal asthma". The articles were assessed based on the
levels of evidence of the GRADE system.Results Only nine original articles were located; two (22%) articles had level of
evidence A, one (11%) had level of evidence B and six (67%) had level of
evidence C.Conclusion The results suggest that noninvasive ventilation is applicable for the
treatment of status asthmaticus in most pediatric patients unresponsive to
standard treatment. However, the available evidence cannot be considered as
conclusive, as further high-quality research is likely to have an impact on
and change the estimate of the effect.