TDNet Discover

Background: Asthma is a common chronic condition that affects much of the world’s population. The disease is classified as an obstructive airway disorder that does not allow adequate air to the lungs, causing patients to experience difficulty breathing. Patients who present with mild symptoms are usually treated with oxygen, a bronchodilator, a nebulizer, corticosteroids, or a combination of these treatments to decrease inflammation. Though patients who experience severe symptoms or fail previous treatments are usually intubated immediately to provide a supportive airway. Objective: To determine if there are sufficient data suggesting that noninvasive ventilation is as effective as intubation for treating patients with asthma exacerbations. Methods: An evidence-based medicine literature review study design was completed by searching databases such as PubMed, ScienceDirect, and Cochrane Library using search phrases like “acute asthma exacerbation non-invasive interventions,” “noninvasive ventilation asthma,” “endotracheal intubation nppv asthma,” and “severe bronchoconstriction treatment”. The following limits were used: within the last 10 years, systematic review, controlled study, meta-analysis, retrospective cohort studies, case studies, access to full text, patients must be human, and studies that are written in English. Study population had to be an asthmatic patient, but chronic obstructive pulmonary disease patients were excluded. An induplicate search and review process were conducted to select the included studies. A quality assessment, level of evidence, and data extraction were utilized to qualitatively analyze each included article. Results: One systematic review and two retrospective cohort studies were included in this review. The patient population was at least 15 years in age and had a primary diagnosis of asthma, some of which had a secondary diagnosis. The studies were measured either by physicians or by ICD-10 diagnostic coding to guarantee adherence. All three articles were ACUTE ASTHMA EXACERBATIONS v rated as “good” for internal validity. The three studies suggest noninvasive ventilation could be utilized to treat acute asthma exacerbations but there was not enough evidence to confirm it as a first-line treatment. They found that after noninvasive ventilation was performed, approximately less than five percent of patients were later intubated. Conclusion: Noninvasive ventilation appears to be a safe and potentially beneficial treatment for asthma exacerbations, but the current research is unable to fully endorse it as being as effective as intubation. The results are promising for non-invasive ventilation, but further research needs to be focused on potential risks for patients with no to multiple co-morbidities, as well as hospital admissions and length of stay, in order to assess the possibility of it as a first-line treatment.