Is non-invasive ventilation safe in acute severe asthma?

Michael Pallin, Mark Hew, Matthew T. Naughton

Research output: Contribution to journalArticleResearchpeer-review

11 Citations (Scopus)

Abstract

Background and objective: The effect of non-invasive ventilation (NIV) in acute severe asthma is unclear and there are concerns regarding its safety.
Methods: 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.
Results: 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 cmH2O 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, P > 0.05) and significantly longer than the control group (42 ± 40 h, P < 0.05).
Conclusions: NIV can be safely used in acute severe asthma although further work is needed to delineate the precise patient selection process.
Original languageEnglish
Pages (from-to)251 - 257
Number of pages7
JournalRespirology
Volume20
Issue number2
DOIs
Publication statusPublished - 2015

Keywords

  • asthma
  • mechanical ventilation
  • morbidity
  • mortality
  • non-invasive ventilation

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