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Noninvasive ventilation in acute severe asthma: current evidence and future perspectives

Carson, Kristin V.a,b,c; Usmani, Zafar A.a,b,c; Smith, Brian J.a,b,c

Current Opinion in Pulmonary Medicine: January 2014 - Volume 20 - Issue 1 - p 118–123
doi: 10.1097/MCP.0000000000000015
ASTHMA: Edited by Nicola A. Hanania and Zuzana Diamant

Purpose of review The use of noninvasive positive pressure ventilation (NPPV) is often employed for the management of acute respiratory failure as an alternative to endotracheal intubation and mechanical ventilation. However, evidence to support the application of NPPV use in patients with acute severe asthma is less known.

Recent findings A paucity of evidence is available to support the use of NPPV as part of clinical care in patients with acute severe asthma. A number of small studies in adult and paediatric populations suggest that NPPV may have a beneficial role through improving respiratory rate and reducing the need for more invasive alternatives. Overall NPPV use appeared to be well tolerated with few reports of adverse events.

Summary Available evidence is limited by a small number of published trials and lack of methodological rigour in existing study design. There is a need for well conducted clinical studies to establish accurate treatment efficacy, safety and cost-effectiveness, in both the adult and paediatric setting.

aRespiratory Medicine, The Queen Elizabeth Hospital, Woodville South

bThe Clinical Practice Unit, Basil Hetzel Institute for Translational Health Research, Woodville South

cSchool of Medicine, The University of Adelaide, Adelaide, South Australia

Correspondence to Kristin Carson, The Queen Elizabeth Hospital, Respiratory Medicine; DX 465 154; 28 Woodville Road, Woodville South, SA 5011, Australia. Tel: +61 08 8222 8685; fax: +61 08 8222 7872; e-mail:

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