Noninvasive Ventilation for Patients with Acute Asthma Exacerbations

For respiratory failure caused by acute asthma exacerbations, standard medical therapy —oxygen, bronchodilators, corticosteroids — is the only formally supported treatment. Available guidelines make no recommendations for or against use of noninvasive ventilation (NIV), because evidence on effectiveness has been lacking.

In this updated systematic review, researchers identified 8 randomized trials and 5 observational studies in which NIV plus standard medical therapy was compared with standard medical therapy alone in adults with acute asthma exacerbations. Overall quality of evidence was low.

The findings were as follows:

• The randomized trials were small and underpowered to detect mortality effects. One large observational study of more than …