Non invasive proportional assist ventilation in management of severe asthma exacerbation

BackgroundNIV could be beneficial in selected patients with severe asthma exacerbation (SAE). However, its role is still not well defined.ObjectiveTo evaluate the efficacy of NIV using proportional assist ventilation (PAV) in severe asthma exacerbation after failure of conventional medical therapt (CMT).Patients and MethodsThirty patients with severe asthma exacerbation were failed to respond on conventional medical therapy. NIV was applied via face mask as a last option before intubation and mechanical ventilation.ResultsThe mean age was 39.2 ± 9.7 with female predominance (19 females vs. 11 males). The successful outcome was achieved in 23/30 patients (76.6%). Follow up of the mean of respiratory distress and gasometric parameters before recruitment vs. 1 h after NIV in successful group showed statistically significant improvement after NIV application as follows: HR (125.4 vs. 107.4), RR (38.2 vs. 25.4), PH (7.28 vs. 7.36), PaCO2 (55.3 vs. 42.5), PaO2 (58 vs. 87) and PEFR% Predicted (39 vs. 64) respectively (P < 0.001 for all items).Also, the same improvement was in PEFR, tidal volume, peak inspiratory pressure and triggered breaths % in successful group vs. failure group.ConclusionNIV can relieve respiratory distress and improve gas exchange in the majority of patients with severe asthma exacerbation who are candidate for intubation after failure of conventional medical therapy.