Cardiopulmonary responses to continuous positive airway pressure in acute asthma

Shivaram, Urmila; Miro, Adelaida M.; Cash, Mary E.; Finch, Peter; Heurich, Albert E.; Kamholz, Stephen L.

doi:10.1016/0883-9441(93)90012-a

Cited by 44 publications

(11 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In patients with severe acute asthma, SHIVARAM et al [96] reported that low levels of CPAP (5 and 7.5 cmH 2 O) by nasal mask produced a significant decrease in breathing frequency and dyspnoea compared with a control group. Neither group of patients showed significant changes in spirometry or blood gases.…”

Section: Diseases Other Than Copdmentioning

confidence: 99%

Noninvasive mechanical ventilation in acute respiratory failure

Ambrosino¹

1996

Eur Respir J

View full text Add to dashboard Cite

show abstract

Section: Diseases Other Than Copdmentioning

confidence: 99%

Noninvasive mechanical ventilation in acute respiratory failure

Ambrosino¹

1996

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…However, there is a paucity of randomized controlled trials on the use of NPPV in asthma. Still, positive results have been reported in a limited number of case reports, case series, or uncontrolled studies with both CPAP and BiPAP (5)(6)(7)(8)(9)(10)(11)(12). In these reports the experience with NPPV in patients with acute severe asthma has been encouraging, but its specific use in the treatment of acute asthma remains poorly defined.…”

mentioning

confidence: 86%

Noninvasive Ventilation

Nowak

Corbridge

Brenner

2009

The Journal of Emergency Medicine

View full text Add to dashboard Cite

“…[22][23][24] Further, BiPAP-delivered beta-agonists have been shown to increase peak expiratory flow rate compared with standard aerosolized beta-agonists in status asthmaticus. 25 However, the potential benefits of BiPAP in status asthmaticus in reducing endotracheal intubation rate, length of hospital stay, and hospital charges have not been studied.…”

Section: Discussionmentioning

confidence: 99%

Ethical Dilemmas in a Randomized Trial of Asthma Treatment Can Bayesian Statistical Analysis Explain the Results?

Holley

Morrissey

Seaberg

et al. 2001

Academic Emergency Medicine

View full text Add to dashboard Cite

Abstract. Objectives: The original objective was to determine whether the use of bilevel positive airway pressure (BiPAP) ventilation would reduce the need for endotracheal intubation, the length of hospital stay, and hospital charges in patients with status asthmaticus. The development of physician treatment bias made patient enrollment difficult. The article subsequently describes the use of Bayesian statistics to explain study results when this bias occurs. Methods: This study was a prospective, randomized controlled clinical trial conducted over a 34.5-month period at an urban university hospital with an emergency department census of 94,000 annual visits. Patients remaining in status asthmaticus after initial standard treatment with inhaled beta-agonists and steroids were randomized to receive BiPAP ventilation plus standard treatment versus standard treatment alone (non-BiPAP), with intubation for either group as needed. Patients with concurrent cardiac or other pulmonary diseases were excluded. The primary outcome measures were endotracheal intubation rate and length of hospital stay. Secondary outcome measures included vital signs (respiratory rate, pulse rate, blood pressure), changes in expiratory peak flow, changes in pulse oximetry values, and hospital charges. Data were analyzed using Fisher's exact test, Mann-Whitney tests, and Bayesian statistics. For patients enrolled in the study more than once, data analysis was performed on the first enrollment only. Results: Nineteen patients were enrolled in the BiPAP group and 16 patients in the nonBiPAP group. Patients were frequently enrolled more than once and the data from the subsequent enrollments were excluded from the analysis. A marked decrease in enrollment, due to physician treatment bias, led to a premature termination of the study. Demographics showed that the groups were similar in age, sex, initial peak flow rate, and arterial blood gas measurements. There was a 7.3% increase (95% CI = Ϫ22 to ϩ45) in the intubation rate in the nonBiPAP group (n = 2) compared with that for the BiPAP group (n = 1). No significant difference was seen in length of hospital stay or hospital charges, although there was a favorable trend toward the BiPAP group. Complications encountered in the BiPAP group included one patient with discomfort associated with the nasal BiPAP mask. Bayesian analysis demonstrated that in order for the collected data to be convincing at the 95% confidence level, the prior conviction among treating physicians that BiPAP was a successful treatment modality would have had to be 98.9%. Conclusions: In this study, BiPAP appeared to have no deleterious effects in patients with status asthmaticus, with a trend toward decreased endotracheal intubation rate, decreased length of hospital stay, and decreased hospital charges. Although further study with more patients is needed to determine the clinical and statistical significance of this intervention, ethical concerns regarding withholding BiPAP treatment from the patients in the control group for...

show abstract

Cardiopulmonary responses to continuous positive airway pressure in acute asthma

Cited by 44 publications

References 13 publications

Noninvasive mechanical ventilation in acute respiratory failure

Noninvasive mechanical ventilation in acute respiratory failure

Noninvasive Ventilation

Ethical Dilemmas in a Randomized Trial of Asthma Treatment Can Bayesian Statistical Analysis Explain the Results?

Contact Info

Product

Resources

About