Acute asthma exacerbation asthma attack acute severe asthma asthma exacerbation
Conditions
Interventions
High flow therapy is delivered by Optiflow cannula using an AIRVO flow source (Fisher &
Paykel
Healthcare Ltd). The initial flow will be set at 30 L/min and can be increased 5 L/min every 15 minutes up to 60 L/min if tolerable. FiO2 will be adjusted to keep oxygen saturation by pulse oxi
Experimental Device,No Intervention No treatment
High-flow nasal cannula,Conventional therapy
Sponsors
Siriraj Research and Development Fund
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Patients with age of 18 years or older 2. Patients previously diagnosed with asthma according to GINA guideline6 3. Patients who present with symptoms compatible with exacerbation according to GINA guideline6 (progressive increase in symptoms of shortness of breath, cough, wheezing or chest tightness and progressive decrease in lung function) 4. Patients who are still eligible meeting the above three criteria after initial standard management for 60 minutes
Exclusion criteria
Exclusion criteria: 1. Patients with respiratory failure; defined as respiratory rate > 35 breaths/min, SpO2 < 90% despite oxygen supplement or signs of increased work of breathing, as observed by use of accessory muscles and abdominal asynchrony. 2. Patients with hemodynamic compromise (blood pressure < 90/60 mmHg) despite intravenous fluid resuscitation 3. Patients with a Glasgow Coma Scale score less than 13 4. Patients with contraindications to the use of equipment with positive airway pressure 5. Patients previously diagnosed with COPD or other chronic lung disease such as interstitial lung disease 6. Patients previously smoking > 5 pack/year 7. Patients concurrently diagnosed with other lower airway conditions such as pneumonia, pulmonary edema 8. Patients who decline to participate 9. Pregnant patients
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| the degree of dyspnea measured with modified Borg scale 2 hours Questionnaire completed by the participant | — |
Secondary
| Measure | Time frame |
|---|---|
| the degree of dyspnea measured with numeric rating scale 2 hours Questionnaire completed by the participant,Respiratory rate 2 hours automated machine,oxygen saturation 2 hours automated machine,end-tidal carbondioxide 2 hours automated machine,pulse rate 2 hours automated machine,blood pressure 2 hours automated machine,the degree of dyspnea measured with visual analog scale 2 hours rate by the study investigators,peak expiratory flow rate 2 hours peak flow meter,treatment escalation 24 hours prospective observation,Adverse events hospital stay prospective observation,length of stay hospital stay prospective observation | — |
Countries
Thailand
Contacts
Public ContactOnlak Ruangsomboon
Department of Emergency Medicine, Siriraj Hospital, Mahidol University
Outcome results
None listed