Noninvasive ventilation use in pediatric status asthmaticus.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
Claire Usala, Patrick Wilson

Abstract

Noninvasive ventilation (NIV) is sometimes used in refractory pediatric status asthmaticus for its potential benefits of stenting airways and dispersing albuterol. However, its effectiveness in pediatric asthma remains unproven. The usage pattern, outcomes, and safety of NIV in pediatric status asthmaticus are described. Patients 1 to 21 years of age admitted to a tertiary hospital's pediatric intensive care unit (PICU) with status asthmaticus between January 2016 and December 2018 were eligible. Children with tracheostomies and baseline NIV were excluded. Medical history, vital signs, imaging, therapy, type of NIV administered and adverse events were extracted from the electronic medical record. 101 unique admissions were identified. The mean age was 7 years, 63% had previously diagnosed asthma and 27% had prior PICU admissions. 54% received NIV in the form of bilevel positive airway pressure (BPAP) or continuous positive airway pressure (CPAP) with 20 (37%) commencing in the emergency department (ED). Oxygen saturation at presentation was significantly lower in the NIV vs the non NIV group (P < 0.05). Rhinovirus/enterovirus was identified in 82% of the cohort. No pneumothoraces, pneumomediastinum, or aspiration pneumonias wer...Continue Reading

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