Mechanical Ventilation for Severe Asthma

Non‐invasive ventilation use in status asthmaticus: 16 years of experience in a tertiary intensive care

“…Our failure rate for NIV was 4.5%, similar to a large American retrospective cohort from an electronic medical record database but less than other studies . Leatherman reports a failure rate of 17% across five studies . Failure rate needs to take into consideration the initial asthma severity and timing of the study as earlier studies appear to have higher failure rates.…”

Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure

“…The acute change in mechanical load (mainly resistive) generates hyperinflation, increased respiratory muscle effort and dyspnoea. Hyperinflation also reduces respiratory muscle efficiency and thus the respiratory muscle pump may ultimately become exhausted, leading to hypercapnia [53].…”

Ventilación mecánica no invasiva en crisis asmática

“…Dentro de estos pacientes, el subgrupo de asma que amenaza la vida tiene una indicación absoluta de ventilación mecánica invasiva, no sólo por insuficiencia respiratoria sino además por el compromiso hemodinánico y/o neurológico asociado (10)(11)(12). En los pacientes con exacerbación asmática severa o moderada la necesidad del soporte ventilatorio, invasivo o no invasivo, dependerá en parte del juicio clínico y de la respuesta al tratamiento farmacológico, los signos clínicos y gasimétricos de fatiga muscular y la alteración del estado de conciencia (8,13,14).…”