Non-invasive Ventilation vs. Standard Therapy for Children Hospitalized With an Acute Exacerbation of Asthma

• Status: Unknown status
• Trial end date: 2018-12-01
• Target enrollment: 0
• Participant gender: All

Summary

Acute asthma produces greatly increased work of breathing and increased oxygen requirement secondary to bronchial narrowing and airway obstruction by inflammatory secretions. There is growing evidence that non-invasive ventilation can reverse these processes more efficiently than conventional asthma therapy. Surprisingly, there have not yet been any large scale prospective controlled studies to investigate this hypothesis, (either in adults or children). Consequently, the aim of this study is to determine if the use of non-invasive positive airway pressure, for children admitted to hospital with an acute exacerbation of asthma, reduces their work of breathing, need for adjunctive medications, and shortens the length of hospital stay, compared to current standard therapy.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University of British Columbia
• Collaborator: Post Graduate Institute of Medical Education and Research, Chandigarh
• Treatments: Albuterol; Aminophylline; Ipratropium; Magnesium Sulfate

Criteria

Inclusion Criteria:

• 2-18 years old

• Clinical diagnosis of acute asthma exacerbation (respiratory rate greater than WHO's age-dependent criteria, a history of similar previous episodes and wheezing heard on auscultation by an experienced physician)

• PRAM score of 8 or more after 2 hours post-steroid administration

• Parents willing and able to sign consent

• Children over the age of 6 willing to provide assent

Exclusion Criteria:

• Clinical suspicion of bacterial pneumonia: focal crackles or bronchial breathing, and/or major chest x-ray findings.

• Impending respiratory failure at presentation requiring direct PICU admission

• Any contraindication to BiPAP use including altered mental status, recent bowel surgery, intractable vomiting, inability to protect airway, pneumothorax.

• Receiving maintenance dose of oral steroid at time of hospital admission

• History of serious unrelated illness such as congenital heart disease or bronchopulmonary dysplasia.