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Noninvasive ventilation in status asthmaticus in children: levels of evidence

Paula de Souza Silva1, Sérgio Saldanha Menna Barreto2

  • 1Hospital da Criança Conceição, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil.

Revista Brasileira De Terapia Intensiva
|January 14, 2016
PubMed

Insights

Noninvasive ventilation may help pediatric patients with severe asthma unresponsive to standard treatments. However, current evidence quality is low, necessitating further research for conclusive guidelines on this pediatric respiratory support method.

Area of Science:

  • Pediatric Pulmonology
  • Critical Care Medicine
  • Respiratory Medicine

Background:

  • Status asthmaticus in children can be life-threatening, often requiring advanced respiratory support.
  • Standard treatments may be insufficient for severe cases of pediatric status asthmaticus.
  • Noninvasive ventilation (NIV) presents a potential therapeutic option for refractory cases.

Purpose of the Study:

  • To assess the quality of evidence supporting the use of noninvasive ventilation for pediatric status asthmaticus.
  • To inform the development of clinical guidelines for NIV in this patient population.

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed, Web of Science, Cochrane, Scopus, SciELO) until September 2014.
  • Included original articles on pediatric asthma and NIV, using comprehensive search terms.
  • Evidence quality was evaluated using the GRADE system.

Main Results:

  • Only nine original articles met the inclusion criteria.
  • The majority of studies (67%) had low-level evidence (GRADE C).
  • A small proportion had high-level evidence (22% GRADE A, 11% GRADE B).

Conclusions:

  • Noninvasive ventilation appears applicable for treating pediatric status asthmaticus unresponsive to standard care.
  • The current evidence base is insufficient to establish definitive guidelines.
  • Further high-quality research is crucial to confirm the efficacy and impact of NIV in pediatric asthma management.
Abstract

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