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Effectiveness of continuous and bilevel positive airway pressure versus standard medical therapy for acute asthma: a randomised controlled trial.

Patients with acute asthma exacerbation (AAE) frequently present at emergency units. The role that non-invasive positive pressure ventilation (NPPV) can play in an AAE remains unanswered although it is frequently used in the clinical setting.

OBJECTIVE: To investigate if the early use of NPPV in the forms of CPAP and BiPAP together with standard medical therapy (ST) in AAE can decrease time of response to therapy compared to ST alone. We further tested the effect of BiPAP against CPAP in AAE.

METHODS: Asthmatic patients presenting with AAE (PEFR % predicted < 60%) at the emergency unit were randomised to ST, ST and CPAP or ST and BiPAP. Groups presented similar baseline characteristics.

RESULTS: Thirty patients fulfilled the inclusion criteria. Respiratory rate and sensation of breathlessness was significantly improved at the end of treatment for both CPAP and BiPAP groups (p = 0.0463; p = 0.0132 respectively) compared to ST alone. Lung function was significantly improved in the CPAP group at the end of treatment (p = 0.0403 for PEFR and p = 0.0293 for PEFR % predicted) compared to ST + BiPAP and ST alone.

CONCLUSION: These results suggest that adding NPPV to ST for an AAE improves clinical signs and lung function faster than ST alone. CPAP seems more effective than BiPAP in ameliorating lung function.
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Article Details
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Title Annotation:Oral Presentations
Author:Hanekom, S.G.; van Aswegen, H.; Eales, C.; Engelbrecht, L.; Becker, P.
Publication:Southern African Journal of Critical Care
Article Type:Clinical report
Geographic Code:6SOUT
Date:Aug 1, 2007
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