Background / Aims: To report the use of non-invasive ventilation (NIV) in adults presenting with status asthmaticus to the Middlemore Hospital Critical Care Complex (CCC) from 2000 to 2015.
Methods: Retrospective review of the notes of all adult patients admitted to the ICU with asthma between 2000 and 2015. Demographic, physiological and treatment data were recorded as well as blood gas results.
Results: There were 265 admissions to Middlemore CCC with asthma during the study period. The median age was 34 years; 64% were female. NIV was used in 186 admissions of which eight went on to require intubation and invasive positive pressure ventilation (IPPV). Twenty-three other admissions received IPPV without a trial of NIV and a further 58 were managed with medical care only. NIV was applied for a mean of 8.7 hours. The ICU and hospital mean lengths of stay (LOS) were 27 hours and 4.1 days respectively. Forty-five admissions presented with a Glasgow Coma Scale (GCS) score of ?10. Twenty-five of these were managed with NIV with only one requiring subsequent intubation. The mean duration of NIV in this group was 5 hours (range 1-17 hours) with a mean ICU and hospital LOS of 17 hours and 3.5 days respectively.
Conclusions: The use of NIV appears to be safe and effective in patients with severe asthma, including selected patients with an altered level of consciousness. NIV was well tolerated with a low need for subsequent intubation. In this series, ICU and hospital LOS were shorter than previously described in the literature.
Counties Manukau Health