Document Detail

Noninvasive Ventilation Coupled With Nebulization During Asthma Crises: A Randomized Controlled Trial.
MedLine Citation:
PMID:  22781558     Owner:  NLM     Status:  Publisher    
BACKGROUND: Despite the clinical improvements attributed to noninvasive ventilation (NIV) during asthma crises and the well-established effects of nebulization, there are few studies on the effects of these interventions together. We hypothesized that nebulization coupled to NIV should rise radioaerosol pulmonary deposition in asthmatics. The aims of this study were: 1) to assess the effects of coupling beta-agonist nebulization and NIV during asthma exacerbations on radioaerosol pulmonary deposition using scintigraphy and in the cardiopulmonary parameters; 2) to correlate pulmonary function with radioaerosol deposition index (RDI), radioaerosol penetration index (RPI) and pulmonary clearance (PC). METHODS: In this controlled trial 21 adults with moderate to severe asthma attack were randomized to a control group (NEB, n=11) or experimental group (NIV+NEB, n=10). All patients inhaled bronchodilators for nine minutes and after particles were counted with a gamma camera to analyze regions of interest and PC at 0, 15, 30, 45 and 60 minutes. RESULTS: Respiratory rate (RR) (p=<0.001) and minute ventilation (VE) (p=0.01) were reduced and tidal volume (VT) was increased (p=0.01) in NIV+NEB group compared with the NEB group. NIV+NEB group had improvement from baseline values compared to NEB group in the following parameters: forced expired volume in one second (FEV₁: 46.7±0.46% pred vs. 29.8±8.87% pred, p=<0.02), forced vital capacity (FVC; 41.2±1.51% pred vs. 23.2±7.12% pred, p=0.02), peak expiratory flow (PEF; 67.3±38.3% pred vs. 26.9±12.15% pred, p=0.01) and inspiratory capacity (IC; 54.92±28.8% pred vs. 31.2±9.06% pred, p=0.01). No differences were observed between groups regarding RDI or PC. Negative correlations were found between FEV₁, FEF25-75%, IC and RPI. CONCLUSION: Coupling nebulization and NIV during asthma exacerbation did not improve radioaerosol pulmonary deposition, but we observed clinical improvement of pulmonary function in these patients.
Valdecir C Galindo-Filho; Armèle Dornelas-de-Andrade; Daniella C Brandão; Rita de Cássia S Ferreira; Maria José C Menezes; Paulo Almeida-Filho; Verônica F Parreira; Tayse N Silva; Maria da Glória Rodrigues-Machado
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-10
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  0020-1324     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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