Purpose of review: Novel therapies, such as a heliox gaseous mixture and noninvasive bilevel positive pressure ventilation, are being utilized in the treatment of the patient with severe asthma who is unresponsive to conventional medical management. Aggressive treatment may prevent intubation and its untoward complications.
Recent findings: Both heliox and bilevel positive pressure ventilation have demonstrated clinical improvement in studies of patients refractory to standard care, both in adults and children.
Summary: The studies in children are limited but show promise, especially when these therapies are used early in the treatment course and in certain subsets of patients.