Early Use of Bilevel Positive Airway Pressure BPAP in Emergency Treatment of Severe Asthma in Children Aged 5 to 17 Years

What this Trial Is About

This trial evaluates the early use of bilevel positive airway pressure BPAP in the emergency department for children aged 5 to 17 years with severe asthma attacks. Researchers aim to assess whether early BPAP is feasible to start soon after arrival, monitor safety events, and compare clinical outcomes like symptom improvement and intensive care needs against standard asthma treatment alone. The study will enroll about 36 children across three sites to inform a future larger trial. Participants will be randomly assigned to receive either BPAP plus continuous albuterol or continuous albuterol alone during a roughly 2-hour intervention period in the emergency department. BPAP is delivered with FDA-approved devices via nasal or face masks managed by clinical staff, with settings adjusted as needed. After this period, further asthma treatment and respiratory support will be decided by the treating clinical team based on patient needs. During the study, participants will be closely monitored in the emergency department and hospital, with clinical data collected from routine care including asthma severity scores, treatments, and outcomes. Researchers will track adherence to the BPAP protocol, changes in asthma severity, duration of continuous albuterol and BPAP use, hospital and intensive care admissions, length of stay, and safety events such as air leak syndrome and vomiting. The participation lasts through hospitalization and data collection up to about 5 days post-randomization.

Bilevel Positive Airway Pressure (BPAP) for Severe Asthma