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Intern Med. 2008;47(6):493-501. Epub 2008 Mar 17.

A prospective and randomized study for improvement of acute asthma by non-invasive positive pressure ventilation (NPPV).

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1
Pulmonary Center, Chiba-Hokuso Hospital, Nippon Medical School, Chiba. soma@nms.ac.jp

Abstract

OBJECTIVE:

We hypothesized that non-invasive positive pressure ventilation (NPPV) would improve an acute asthma attack in mild to moderate cases without bronchodilator therapy.

METHODOLOGY:

A total of 44 eligible patients with acute asthma of mild to moderate severity who had acute attacks were randomly allocated to a NPPV (n=30) or control group (n=14). Both groups received intravenous infusion of hydrocortisone prior to the study. Patients in the NPPV group were divided into two subgroups at random: a high- (n=16) and a low-pressure group (n=14). The former had a fixed expiratory positive airway pressure and inspiratory positive airway pressure of 6 cmH2O and 8 cmH2O, respectively, while the latter had levels of 4 cmH2O and 6 cmH2O, respectively. Effects on the following variables were assessed: FEV(1), oxygen saturation, heart rate, respiratory rate, scores of accessory muscle use and wheezing by auscultation, modified Borg scale score, and mean intra-airway pressure on the monitor.

RESULTS:

A total of 26 patients completed the study in the NPPV group. The mean percent change in FEV(1) significantly improved after 40 minutes in the high-pressure group compared with that in the control group (p<0.0001). Similar significant improvements in modified Borg scale score and physical examination findings were observed in the high- and low-pressure groups. None of the patients required re-hospitalization or return to the emergency room in either the NPPV or control group.

CONCLUSION:

We conclude that higher inflation pressure on NPPV led to clinical improvement in patients with acute asthma attacks of mild to moderate severity.

PMID:
18344635
[Indexed for MEDLINE]
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