Is non‐invasive ventilation safe in acute severe asthma?. Issue 2 (6th November 2014)

• Record Type: Journal Article
• Authors: Pallin, Michael; Hew, Mark; Naughton, Matthew T.
• Is Part Of: Respirology. Volume 20:Issue 2(2015)
• Page Start: 251
• Page End: 257
• Publication Date: 2014-11-06
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 612.2
• DOI: 10.1111/resp.12428
• Languages: English
• ISSNs: 1323-7799

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="resp12428-sec-0001" sec-type="section"> <title>Background and objective</title> <p>The effect of non‐invasive ventilation (NIV) in acute severe asthma is unclear and there are concerns regarding its safety.</p> </sec> <sec id="resp12428-sec-0002" sec-type="section"> <title>Methods</title> <p>We undertook a 5‐year case–control review of mortality and morbidity associated with NIV use in acute severe asthma and compared this with asthma requiring invasive mechanical ventilation (IMV) and a control group with less severe asthma without ventilatory support.</p> </sec> <sec id="resp12428-sec-0003" sec-type="section"> <title>Results</title> <p>Eight hundred seventy‐three patients had acute severe asthma of whom 30 were treated with NIV, 17 with IMV and 90 served as controls. The mean duration of NIV was 9.5 ± 7.3 h with inspiratory positive airway pressure and expiratory positive airway pressure of 11.9 ± 1.4 and 5.8 ± 1.2 cmH<sub>2</sub>O respectively. Mortality was zero in the NIV and control groups, compared with 41% in the IMV group. None of the NIV or control groups required escalation to invasive ventilation. There were no instances of haemodynamic compromise in the NIV or control groups. Length of hospital stay was 121 ± 96 h in the NIV group and similar to the severe IMV group (136 ± 99 h, <italic>P</italic> > 0.05) and significantly longer than the control group (42 ± 40 h, <italic>P</italic> < 0.05).</p> </sec> <sec id="resp12428-sec-0004" sec-type="section"> <title>Conclusions</title> <p>NIV can be safely used in acute severe asthma although further work is needed to delineate the precise patient selection process.</p> </sec> </abstract>