Abstract

Asthma attack is characterized by episodic attacks of cough, dyspnea and wheeze occurring due to bronchoconstriction, airway hyperresponsiveness and mucous hypersecretion. Although nationwide clinical guidelines have been published to establish the standard care of asthma, choices in the treatment of fatal asthma attacks remain of clinical significance. Especially, in a severe asthma attack, despite the application of conventional medical treatment, respiratory management is critical. Even though non-invasive ventilation (NIV) has been shown to be effective in a wide variety of clinical settings, reports of NIV in asthmatic patients are scarce. According to a few prospective clinical trials reporting promising results in favour of the use of NIV in a severe asthma attack, a trial of NIV prior to invasive mechanical ventilation seems acceptable and may benefit patients by decreasing the need for intubation and by supporting pharmaceutical treatments. Although selecting the appropriate patients for NIV use is a key factor in successful NIV application, how to distinguish such patients is quite controversial. Larger high quality clinical trails are urgently required to confirm the benefits of NIV to patients with severe asthma attack. In this article, we focus on the body of evidence supporting the use of NIV in asthma attacks and discuss its advantages as well its problems.

Links

Publisher Full Text

Authors

Murase K, Tomii K, Chin K, Niimi A, Ishihara K, Mishima M

Institution

Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. publicboy1125@hotmail.com

Source

Panminerva medica 53:2 2011 Jun pg 87-96

MeSH

Asthma
Bronchi
Clinical Trials as Topic
Humans
Inflammation
Patient Selection
Positive-Pressure Respiration
Pulmonary Alveoli
Pulmonary Gas Exchange
Pulmonary Medicine
Pulmonary Ventilation
Respiration
Respiration, Artificial
Standard of Care

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21659974