Noninvasive ventilation in acute asthma
* Dr. Shahkar, L. MD, Assistant professor of pediatric pulmonology . Golestan University of Medical Science.
non- invasive Mechanical Ventilation is a common form of ventilation in the most advanced ICU in developed countries.
in non- invasive Mechanical Ventilation the patient receives respiratory support through a tight fitting mask applied to their face. The use of NIV in the acute asthma setting has been shown to be associated with improvements in important physiological variables including measures of airflow and respiratory rate, and lends support to further study in this field.
Improvements in airflow may be a direct effect of applied positive airway pressure or an indirect effect secondary to better dispersal of aerosolized medication.
Reductions observed in respiratory rate and dyspnea are likely influenced by the amount of pressure support provided.
Evidence suggestive of any improvement in mortality, intubation rate, or hospital/intensive care unit length of stay, NIV eases the work of breathing in patients who are progressing toward respiratory muscle fatigue.
Toddlers and small children may require mild sedation to tolerate the mask. NIV is absolutely contraindicated in the following situations:
The most important parameters of clinical course are
PaCO2 (the arterial partial pressure of carbon dioxide), pH,
respiratory rate, dyspnea, and alertness; these must show
a trend toward improvement in the first 2 hours of NIV.