Title: A Prospective, Randomized Controlled Trial of Noninvasive Ventilation in Acute Exacerbation of Asthma in Children
Authors: Dr Md Rahiul Islam MBBS, Dr Sudip Saha MD, Prof. Dr Sutapa Ganguly MD, Prof. Madhusmita Sen Gupta MD, Dr Sandipta Ray MD, Dr Amit Mandal MD, Dr Kuntal Kanti Das MD, Dr Sudipta Ghorai MBBS
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.103
Abstract
Objective: To compare the benefits of noninvasive ventilation (NIV) plus standard therapy vs standard therapy alone in children with acute exacerbation of asthma.
Design: Randomized control trial.
Setting: Tertiary care Pediatric Intensive Care Unit (PICU), duration of study from October 2014 to September 2016.
Participants: Three month to twelve years with acute severe asthma (<24 hours) with initial Becker Score >7 were eligible for this study.
Interventions: The study group received NIV under inspiratory positive airway pressure ranging between 10 cm - 18 cm H2O, expiratory positive airway pressure between 4 cm - 12 cm H2O. Vital signs, PO2, PCO2, pH, SPO2 , becker score were recorded at the start, 1, 2, 4, 12, 24, and 48 hrs into the study.
Result: Heart rate after four hour and twelve hour and respiratory rate after two hour of treatment were significantly lower compared with admission (p = 0.0001 and p = 0.0294, respectively). With NIV, PO2 at four hour, SPO2 at two hour improved significantly. The endotracheal intubation was significantly lower (22%) in the NIV group than in the control group (45%; p = 0.01698).There was significant difference in length of stay in PICU (p= 0.0109) and hospital (p = 0.0115).
Conclusion: NIV seems to afford these children protection from endotracheal intubation and reduced in length of stay in PICU and hospital.
Keywords: Non Invasive Mechanical Ventilation, Asthma.
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