Saves the questions and what to expect into your notes, next to the visit they belong to.
Keep this study
Lead
University of British Columbia
Children aged 2 - 18 years presenting to the Emergency Department (ED) with a moderate or severe asthma exacerbation (Pediatric Respiratory Assessment Measure (PRAM) of \> 3) who fail to improve clinically with standard ED management with inhaled salbutamol and ipratropium will be randomized to receive either standard asthma management according to our local severe asthma guideline or management with BiPAP in addition to standard care. Both groups will receive a comparable dose of systemic steroid and hourly salbutamol inhalers with subsequent weaning according to PRAM score. Patients randomized to receive BiPAP will be admitted to the Pediatric Intensive Care Unit (PICU) and those randomized to the control group will be admitted to the medical ward. Both groups will be monitored with 3-hourly PRAM scoring through the duration of their admission.
Age
2–18
Sex
ALL
Healthy volunteers
Not accepted
You may be eligible if
2-18 years old
Admitted to BC Children's Hospital with a clinical diagnosis of an acute asthma exacerbation
PRAM score of \>3 following initial treatment with three rounds of inhaled salbutamol and ipratropium bromide, and one dose of systemic steroid
Parents willing and able to sign consent
Children over the age of 6 willing to provide assent
You may not be if
Clinical suspicion of co-existing bacterial pneumonia: focal crackles or bronchial breathing, and/or major chest x-ray findings
Impending respiratory failure at presentation requiring direct PICU admission
Receiving maintenance dose of oral steroid at time of hospital admission
Any contraindication to BiPAP use including altered mental status, recent bowel surgery, intractable vomiting, or inability to protect airway
Current tracheostomy, home ventilation (IPPV or NIPPV) or home oxygen requirement
History of congenital heart disease or chronic respiratory disease (including bronchopulmonary dysplasia, cystic fibrosis, pulmonary hypertension)
Craniofacial abnormality precluding the use of a tight fitting facial mask
Clareo Health | Bilevel Positive Airway Pressure (BiPAP) for the Treatment of Moderate to Severe Acute Asthma Exacerbations
