Non-Invasive Ventilation in Severe Acute Exacerbation of Asthma

Abstract

Non-invasive ventilation (NIV) has now an important place in intensive care unit. Its recommended indications are acute exacerbations of chronic obstructive pulmonary diseases and acute cardiac failure. In the last consensus conference of three scientific societies (SRLF, SPLF and SFAR) in 2006, no recommendation has been proposed on the indication of NIV in respiratory failure due to severe asthma exacerbation. From a pathophysiological point of view, there is a real rationale for the use of NIV in asthma. The published studies in this area do not help us to conclude on this point. Only small and heterogeneous groups of patients are included in these studies, the tolerance data are missing and the judgment criteria are not appropriate (only spirometric data, rarely mortality or intubation rate). New studies in this field are required to conclude on the indication of NIV in respiratory failure due to severe asthma exacerbation.