Noninvasive positive pressure ventilation for the treatment of status asthmaticus in children.
BACKGROUND
Noninvasive positive pressure ventilation (NPPV) has been used safely and effectively to improve gas exchange and to treat respiratory failure in a variety of disease states. Although this technique has some benefits in the treatment of status asthmaticus in adults, the use of NPPV in pediatric patients with asthma has not been described.


OBJECTIVE
To describe the use of NPPV in the treatment of pediatric status asthmaticus.


METHODS
Retrospective review of children admitted to the intensive care unit with asthma who received NPPV as part of their treatment between October 2002 and April 2004. Before and after initiation of NPPV, data were collected regarding degree of respiratory dysfunction.


RESULTS
Of seventy-nine children admitted to the intensive care unit during the study period for treatment of status asthmaticus, 5 children (mean +/- SD age, 9.6 +/- 4.2 years) were treated with NPPV. Four of the 5 children were morbidly obese, with a mean +/- SD body mass index of 32 +/- 5. There was a statistically significant improvement in respiratory rate (43 +/- 20 vs 31 +/- 12/min, P = .03) and Modified Pulmonary Index Score (13.4 +/- 1.8 vs 11.4 +/- 1.5, P = .03) after initiation of NPPV. The mean +/- SD duration of therapy was 33.2 +/- 23.9 hours, and children tolerated this therapy well, requiring little or no anxiolytics.


CONCLUSIONS
NPPV was well tolerated in this series of children with status asthmaticus and can improve subjective and objective measures of respiratory dysfunction. NPPV may be a useful adjunct in the treatment of status asthmaticus in children.
Carroll
Christopher L
CL
Department of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut 06106, USA. ccarrol@ccmckids.org
Schramm
Craig M
CM
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods*; D005260:Female; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation; D008297:Male; D012189:Retrospective Studies; D013224:Status Asthmaticus / Q000628:therapy*; D016896:Treatment Outcome