title: Noninvasive ventilation in acute severe asthma: current evidence and future perspectives.
abstract: OBJECTIVE
  The use of noninvasive positive pressure ventilation (NPPV) is often employed for the management of acute respiratory failure as an alternative to endotracheal intubation and mechanical ventilation. However, evidence to support the application of NPPV use in patients with acute severe asthma is less known.
  
  
  RESULTS
  A paucity of evidence is available to support the use of NPPV as part of clinical care in patients with acute severe asthma. A number of small studies in adult and paediatric populations suggest that NPPV may have a beneficial role through improving respiratory rate and reducing the need for more invasive alternatives. Overall NPPV use appeared to be well tolerated with few reports of adverse events.
  
  
  CONCLUSIONS
  Available evidence is limited by a small number of published trials and lack of methodological rigour in existing study design. There is a need for well conducted clinical studies to establish accurate treatment efficacy, safety and cost-effectiveness, in both the adult and paediatric setting.
authors.affiliation: aRespiratory Medicine, The Queen Elizabeth Hospital, Woodville South bThe Clinical Practice Unit, Basil Hetzel Institute for Translational Health Research, Woodville South cSchool of Medicine, The University of Adelaide, Adelaide, South Australia.
authors.forename: Kristin V
authors.initials: KV
authors.lastname: Carson
authors.forename: Zafar A
authors.initials: ZA
authors.lastname: Usmani
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Smith
mesh_terms: D000208:Acute Disease; D001249:Asthma / Q000150:complications / Q000628:therapy*; D003362:Cost-Benefit Analysis; D006801:Humans; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome