Bilevel positive airway pressure in the treatment of status asthmaticus in pediatrics

Sara L. Beers, Thomas J. Abramo, Andrea Bracken, Robert A. Wiebe

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Objectives: The aim of this study was to examine the safety, patient tolerance, and possible benefit of bilevel positive airway pressure (BiPAP) in conjunction with β-2 agonist therapy in the treatment of pediatric patients with status asthmaticus who were refractory to conventional medical therapy. Methods: This descriptive retrospective chart review examined all patients with the diagnosis of acute asthma treated with BiPAP in an urban academic pediatric emergency department (ED) from April 1, 2003, to August 31, 2004. Results: Eighty-three patients with status asthmaticus refractory to conventional pharmacological treatment were placed on BiPAP with β-2 agonist nebulization in the ED. The number of subjects tolerating BiPAP was 73 (88%) of 83 patients. All patients placed on BiPAP in the ED were initially designated for admission to the pediatric intensive care unit (PICU). However, only 78% (57/73) were actually admitted to the PICU. Sixteen patients on BiPAP were admitted to a ward service; of these patients, none were subsequently transferred to the PICU. In addition, there was an immediate improvement in subjects' clinical status upon initiation of BiPAP, with 77% showing a decrease in respiratory rate, averaging 23.6% (range, 4%-50%), and 88% showing an improved oxygen saturation, averaging 6.6 percentage points (1-28 percentage points). There were no adverse events due to the use of BiPAP. Conclusions: These results suggest that the addition of BiPAP in treating pediatric status asthmaticus is safe and well tolerated. This intervention shows promise as a beneficial adjunct to conventional medical treatments. However, further prospective investigation is warranted to confirm these findings.

Original languageEnglish (US)
Pages (from-to)6-9
Number of pages4
JournalAmerican Journal of Emergency Medicine
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2007

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Status Asthmaticus
Pediatrics
Pressure
Pediatric Intensive Care Units
Hospital Emergency Service
Therapeutics
Patient Safety
Respiratory Rate
Asthma
Pharmacology
Oxygen

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Bilevel positive airway pressure in the treatment of status asthmaticus in pediatrics. / Beers, Sara L.; Abramo, Thomas J.; Bracken, Andrea; Wiebe, Robert A.

In: American Journal of Emergency Medicine, Vol. 25, No. 1, 01.01.2007, p. 6-9.

Research output: Contribution to journalArticle

Beers, Sara L. ; Abramo, Thomas J. ; Bracken, Andrea ; Wiebe, Robert A. / Bilevel positive airway pressure in the treatment of status asthmaticus in pediatrics. In: American Journal of Emergency Medicine. 2007 ; Vol. 25, No. 1. pp. 6-9.
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