<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03296579</url>
  </required_header>
  <id_info>
    <org_study_id>H17-02008</org_study_id>
    <nct_id>NCT03296579</nct_id>
  </id_info>
  <brief_title>Non-invasive Ventilation vs. Standard Therapy for Children Hospitalized With an Acute Exacerbation of Asthma</brief_title>
  <official_title>A Prospective Open Randomized Clinical Trial of Non-invasive Ventilation Versus Standard Therapy for Children Hospitalized With an Acute Exacerbation of Asthma.</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>University of British Columbia</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Post Graduate Institute of Medical Education and Research, Chandigarh</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>University of British Columbia</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Acute asthma produces greatly increased work of breathing and increased oxygen requirement&#xD;
      secondary to bronchial narrowing and airway obstruction by inflammatory secretions. There is&#xD;
      growing evidence that non-invasive ventilation can reverse these processes more efficiently&#xD;
      than conventional asthma therapy. Surprisingly, there have not yet been any large scale&#xD;
      prospective controlled studies to investigate this hypothesis, (either in adults or&#xD;
      children). Consequently, the aim of this study is to determine if the use of non-invasive&#xD;
      positive airway pressure, for children admitted to hospital with an acute exacerbation of&#xD;
      asthma, reduces their work of breathing, need for adjunctive medications, and shortens the&#xD;
      length of hospital stay, compared to current standard therapy.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      The aim of the study is to determine if the use of NIV, for children admitted to hospital&#xD;
      with an acute exacerbation of asthma, reduces their work of breathing, need for adjunctive&#xD;
      medication, length of hospital stay, and need for intubation and mechanical ventilation.&#xD;
      Study design will be prospective, randomized and controlled. The tightly fitting face mask&#xD;
      necessary for NIV makes it impossible to make this a blinded study.&#xD;
&#xD;
      The principal enrollment criteria will be children over 2 years of age presenting to the ER&#xD;
      with acute asthma. After diagnosis, all children are treated with standard therapy (systemic&#xD;
      steroids plus 3 doses of inhaled salbutamol and 1 dose of inhaled ipratropium over a 1 hour&#xD;
      period then hourly salbutamol). The principal decision between discharge track and admission&#xD;
      track will be made at 2 hours after first steroid dose. Admission criteria are based on&#xD;
      sequential PRAM scores.&#xD;
&#xD;
      After initial asthma treatment and observation in the emergency room, to determine which&#xD;
      patients can be discharged home, those who need admission will be asked to join the study,&#xD;
      then consented and randomized. There will be three treatment groups:&#xD;
&#xD;
        -  BiPAP: standard steroid dose, hourly salbutamol and BiPAP at 15/5 cm H2O by face mask&#xD;
           with rate 10 to 15/min, oxygen as needed.&#xD;
&#xD;
        -  CPAP: standard steroid dose, hourly salbutamol and 8 to 10 cm H2O constant pressure by&#xD;
           face mask, oxygen as needed.&#xD;
&#xD;
        -  Conventional therapy: standard steroid dose plus hourly nebulized salbutamol, nebulized&#xD;
           ipratropium q 6 hrly, magnesium sulphate 50 mg/kg IV (4 doses q 6 hrly), loading dose of&#xD;
           aminophylline 6 mg/kg IV if no progress, oxygen as needed.&#xD;
&#xD;
      All children will be admitted to a small 3 bed respiratory unit. They will be closely&#xD;
      monitored and objectively scored every 4 hours using the PRAM asthma clinical severity score&#xD;
      (Pediatric Respiratory Assessment Measure). Projected patient enrollment will be at least 30&#xD;
      in each arm. Estimated study duration is 6 months.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Not yet recruiting</last_known_status>
  <start_date type="Anticipated">June 2018</start_date>
  <completion_date type="Anticipated">December 2018</completion_date>
  <primary_completion_date type="Anticipated">November 2018</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
    <masking_description>It is not possible to use non-invasive face masks on the control patients so the study is unblinded.</masking_description>
  </study_design_info>
  <primary_outcome>
    <measure>Time to reach a PRAM score of ≤3</measure>
    <time_frame>Patients will be followed for the duration of their hospital stay (an estimated average duration of 4 days)</time_frame>
    <description>PRAM score includes assessment of oxygen saturations, suprasternal retractions, scalene muscle contraction, air entry and wheezing.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Time to room air</measure>
    <time_frame>Patients will be followed for the duration of their hospital stay (an estimated average of 4 days).</time_frame>
    <description>Time that oxygen is required</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Total medication use per 12 hr period</measure>
    <time_frame>Patients will be followed for the duration of their hospital stay (an estimated average of 4 days).</time_frame>
    <description>Comparison of total medication use by children in each arm.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Numbers failing treatment and transferred to ICU</measure>
    <time_frame>Patients will be followed for the duration of their hospital stay (an estimated average of 4 days).</time_frame>
    <description>Number of patients in each group that fail treatment and require transfer to ICU</description>
  </secondary_outcome>
  <other_outcome>
    <measure>Time to reach FEV1 &gt;80% predicted in those children able to perform pulmonary function tests</measure>
    <time_frame>Patients will be followed for the duration of their hospital stay (an estimated average of 4 days).</time_frame>
    <description>Standard pulmonary function tests can usually be performed by children &gt;6 years.</description>
  </other_outcome>
  <number_of_arms>3</number_of_arms>
  <enrollment type="Anticipated">100</enrollment>
  <condition>Asthma Acute</condition>
  <condition>Asthma in Children</condition>
  <arm_group>
    <arm_group_label>Conventional asthma therapy.</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Bilevel Positive Airway Pressure group(BiPAP). BiPAP settings at 15/5 cm H2O by face mask with background rate 10 to 15/min. Standard steroid dose plus hourly salbutamol and oxygen to keep SaO2 &gt; 92%.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Non-invasive ventilation (CPAP).</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Continuous Positive Airway Pressure group (CPAP). CPAP settings at 8 to 10 cm H2O. Standard steroid dose plus hourly salbutamol and oxygen to keep SaO2 &gt; 92%.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Non-invasive ventilation (BiPAP)</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Standard steroid dose, hourly salbutamol, oxygen as needed, nebulized ipratropium q 6 hrly, magnesium sulfate 50 mg/kg IV (4 doses q 6 hrly), loading dose of aminophylline 6 mg/kg IV if no progress.</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>BiPAP</intervention_name>
    <description>The patient's breathing is assisted by cycling between high and low pressures at a pre-set rate.</description>
    <arm_group_label>Non-invasive ventilation (BiPAP)</arm_group_label>
    <other_name>Trilogy BiPAP</other_name>
    <other_name>Bilevel Positive Airway Pressure</other_name>
  </intervention>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>CPAP</intervention_name>
    <description>The patient breathes against a constant pressure delivered by face mask.</description>
    <arm_group_label>Non-invasive ventilation (CPAP).</arm_group_label>
    <other_name>Continuous Positive Airway Pressure</other_name>
  </intervention>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Ipratropium</intervention_name>
    <description>Nebulized q6h</description>
    <arm_group_label>Conventional asthma therapy.</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Magnesium Sulfate</intervention_name>
    <description>50mg/kg IV, 4 doses q6h</description>
    <arm_group_label>Conventional asthma therapy.</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Aminophylline</intervention_name>
    <description>6mg/kg IV (if no progress)</description>
    <arm_group_label>Conventional asthma therapy.</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Standard steroid dose, hourly salbutamol, oxygen as needed</intervention_name>
    <description>Standard common therapies for all three arms.</description>
    <arm_group_label>Conventional asthma therapy.</arm_group_label>
    <arm_group_label>Non-invasive ventilation (BiPAP)</arm_group_label>
    <arm_group_label>Non-invasive ventilation (CPAP).</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  2-18 years old&#xD;
&#xD;
          -  Clinical diagnosis of acute asthma exacerbation (respiratory rate greater than WHO's&#xD;
             age-dependent criteria, a history of similar previous episodes and wheezing heard on&#xD;
             auscultation by an experienced physician)&#xD;
&#xD;
          -  PRAM score of 8 or more after 2 hours post-steroid administration&#xD;
&#xD;
          -  Parents willing and able to sign consent&#xD;
&#xD;
          -  Children over the age of 6 willing to provide assent&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Clinical suspicion of bacterial pneumonia: focal crackles or bronchial breathing,&#xD;
             and/or major chest x-ray findings.&#xD;
&#xD;
          -  Impending respiratory failure at presentation requiring direct PICU admission&#xD;
&#xD;
          -  Any contraindication to BiPAP use including altered mental status, recent bowel&#xD;
             surgery, intractable vomiting, inability to protect airway, pneumothorax.&#xD;
&#xD;
          -  Receiving maintenance dose of oral steroid at time of hospital admission&#xD;
&#xD;
          -  History of serious unrelated illness such as congenital heart disease or&#xD;
             bronchopulmonary dysplasia.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>2 Years</minimum_age>
    <maximum_age>18 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Michael Seear</last_name>
    <role>Principal Investigator</role>
    <affiliation>University of British Columbia</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Michael Seear, MD</last_name>
    <phone>6048752000</phone>
    <email>mseear@cw.bc.ca</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Terry Viczko</last_name>
    <phone>6048752345</phone>
    <phone_ext>5419</phone_ext>
    <email>tviczko@bcchr.ca</email>
  </overall_contact_backup>
  <reference>
    <citation>Gowraiah V, Awasthi S, Kapoor R, Sahana D, Venkatesh P, Gangadhar B, Awasthi A, Verma A, Pai N, Seear M. Can we distinguish pneumonia from wheezy diseases in tachypnoeic children under low-resource conditions? A prospective observational study in four Indian hospitals. Arch Dis Child. 2014 Oct;99(10):899-906. doi: 10.1136/archdischild-2013-305740. Epub 2014 Jun 12.</citation>
    <PMID>24925892</PMID>
  </reference>
  <reference>
    <citation>Basnet S, Mander G, Andoh J, Klaska H, Verhulst S, Koirala J. Safety, efficacy, and tolerability of early initiation of noninvasive positive pressure ventilation in pediatric patients admitted with status asthmaticus: a pilot study. Pediatr Crit Care Med. 2012 Jul;13(4):393-8. doi: 10.1097/PCC.0b013e318238b07a.</citation>
    <PMID>22067982</PMID>
  </reference>
  <reference>
    <citation>Ducharme FM, Chalut D, Plotnick L, Savdie C, Kudirka D, Zhang X, Meng L, McGillivray D. The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers. J Pediatr. 2008 Apr;152(4):476-80, 480.e1. doi: 10.1016/j.jpeds.2007.08.034. Epub 2007 Oct 31.</citation>
    <PMID>18346499</PMID>
  </reference>
  <reference>
    <citation>Martinez FD, Vercelli D. Asthma. Lancet. 2013 Oct 19;382(9901):1360-72. doi: 10.1016/S0140-6736(13)61536-6. Epub 2013 Sep 13.</citation>
    <PMID>24041942</PMID>
  </reference>
  <reference>
    <citation>Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet. 2009 Jul 18;374(9685):250-9. doi: 10.1016/S0140-6736(09)60496-7.</citation>
    <PMID>19616722</PMID>
  </reference>
  <reference>
    <citation>British Thoracic Society Standards of Care Committee. Non-invasive ventilation in acute respiratory failure. Thorax. 2002 Mar;57(3):192-211. doi: 10.1136/thorax.57.3.192. No abstract available.</citation>
    <PMID>11867822</PMID>
  </reference>
  <reference>
    <citation>Nievas IF, Anand KJ. Severe acute asthma exacerbation in children: a stepwise approach for escalating therapy in a pediatric intensive care unit. J Pediatr Pharmacol Ther. 2013 Apr;18(2):88-104. doi: 10.5863/1551-6776-18.2.88.</citation>
    <PMID>23798903</PMID>
  </reference>
  <reference>
    <citation>Papiris SA, Manali ED, Kolilekas L, Triantafillidou C, Tsangaris I. Acute severe asthma: new approaches to assessment and treatment. Drugs. 2009;69(17):2363-91. doi: 10.2165/11319930-000000000-00000.</citation>
    <PMID>19911854</PMID>
  </reference>
  <reference>
    <citation>Green E, Jain P, Bernoth M. Noninvasive ventilation for acute exacerbations of asthma: A systematic review of the literature. Aust Crit Care. 2017 Nov;30(6):289-297. doi: 10.1016/j.aucc.2017.01.003. Epub 2017 Jan 27.</citation>
    <PMID>28139368</PMID>
  </reference>
  <reference>
    <citation>Soroksky A, Klinowski E, Ilgyev E, Mizrachi A, Miller A, Ben Yehuda TM, Shpirer I, Leonov Y. Noninvasive positive pressure ventilation in acute asthmatic attack. Eur Respir Rev. 2010 Mar;19(115):39-45. doi: 10.1183/09059180.00006109.</citation>
    <PMID>20956164</PMID>
  </reference>
  <verification_date>April 2018</verification_date>
  <study_first_submitted>September 21, 2017</study_first_submitted>
  <study_first_submitted_qc>September 25, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">September 28, 2017</study_first_posted>
  <last_update_submitted>April 30, 2018</last_update_submitted>
  <last_update_submitted_qc>April 30, 2018</last_update_submitted_qc>
  <last_update_posted type="Actual">May 2, 2018</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>University of British Columbia</investigator_affiliation>
    <investigator_full_name>Michael Seear</investigator_full_name>
    <investigator_title>Principal Investigator</investigator_title>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Asthma</mesh_term>
  </condition_browse>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Magnesium Sulfate</mesh_term>
    <mesh_term>Aminophylline</mesh_term>
    <mesh_term>Albuterol</mesh_term>
    <mesh_term>Ipratropium</mesh_term>
  </intervention_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <provided_document_section>
    <provided_document>
      <document_type>Study Protocol and Statistical Analysis Plan</document_type>
      <document_has_protocol>Yes</document_has_protocol>
      <document_has_icf>No</document_has_icf>
      <document_has_sap>Yes</document_has_sap>
      <document_date>September 27, 2017</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/79/NCT03296579/Prot_SAP_004.pdf</document_url>
    </provided_document>
    <provided_document>
      <document_type>Informed Consent Form</document_type>
      <document_has_protocol>No</document_has_protocol>
      <document_has_icf>Yes</document_has_icf>
      <document_has_sap>No</document_has_sap>
      <document_date>September 27, 2017</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/79/NCT03296579/ICF_005.pdf</document_url>
    </provided_document>
  </provided_document_section>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03296579
org study id: H17-02008
nct id: NCT03296579
lead sponsor: 
collaborator: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
Acute asthma produces greatly increased work of breathing and increased oxygen requirement
      secondary to bronchial narrowing and airway obstruction by inflammatory secretions. There is
      growing evidence that non-invasive ventilation can reverse these processes more efficiently
      than conventional asthma therapy. Surprisingly, there have not yet been any large scale
      prospective controlled studies to investigate this hypothesis, (either in adults or
      children). Consequently, the aim of this study is to determine if the use of non-invasive
      positive airway pressure, for children admitted to hospital with an acute exacerbation of
      asthma, reduces their work of breathing, need for adjunctive medications, and shortens the
      length of hospital stay, compared to current standard therapy.
The aim of the study is to determine if the use of NIV, for children admitted to hospital
      with an acute exacerbation of asthma, reduces their work of breathing, need for adjunctive
      medication, length of hospital stay, and need for intubation and mechanical ventilation.
      Study design will be prospective, randomized and controlled. The tightly fitting face mask
      necessary for NIV makes it impossible to make this a blinded study.

      The principal enrollment criteria will be children over 2 years of age presenting to the ER
      with acute asthma. After diagnosis, all children are treated with standard therapy (systemic
      steroids plus 3 doses of inhaled salbutamol and 1 dose of inhaled ipratropium over a 1 hour
      period then hourly salbutamol). The principal decision between discharge track and admission
      track will be made at 2 hours after first steroid dose. Admission criteria are based on
      sequential PRAM scores.

      After initial asthma treatment and observation in the emergency room, to determine which
      patients can be discharged home, those who need admission will be asked to join the study,
      then consented and randomized. There will be three treatment groups:

        -  BiPAP: standard steroid dose, hourly salbutamol and BiPAP at 15/5 cm H2O by face mask
           with rate 10 to 15/min, oxygen as needed.

        -  CPAP: standard steroid dose, hourly salbutamol and 8 to 10 cm H2O constant pressure by
           face mask, oxygen as needed.

        -  Conventional therapy: standard steroid dose plus hourly nebulized salbutamol, nebulized
           ipratropium q 6 hrly, magnesium sulphate 50 mg/kg IV (4 doses q 6 hrly), loading dose of
           aminophylline 6 mg/kg IV if no progress, oxygen as needed.

      All children will be admitted to a small 3 bed respiratory unit. They will be closely
      monitored and objectively scored every 4 hours using the PRAM asthma clinical severity score
      (Pediatric Respiratory Assessment Measure). Projected patient enrollment will be at least 30
      in each arm. Estimated study duration is 6 months.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: None (Open Label)
masking description: It is not possible to use non-invasive face masks on the control patients so the study is unblinded.
measure: Time to reach a PRAM score of ≤3
time frame: Patients will be followed for the duration of their hospital stay (an estimated average duration of 4 days)
description: PRAM score includes assessment of oxygen saturations, suprasternal retractions, scalene muscle contraction, air entry and wheezing.
measure: Time to room air
time frame: Patients will be followed for the duration of their hospital stay (an estimated average of 4 days).
description: Time that oxygen is required
measure: Total medication use per 12 hr period
time frame: Patients will be followed for the duration of their hospital stay (an estimated average of 4 days).
description: Comparison of total medication use by children in each arm.
measure: Numbers failing treatment and transferred to ICU
time frame: Patients will be followed for the duration of their hospital stay (an estimated average of 4 days).
description: Number of patients in each group that fail treatment and require transfer to ICU
measure: Time to reach FEV1 >80% predicted in those children able to perform pulmonary function tests
time frame: Patients will be followed for the duration of their hospital stay (an estimated average of 4 days).
description: Standard pulmonary function tests can usually be performed by children >6 years.
arm group label: Conventional asthma therapy.
arm group type: Active Comparator
description: Bilevel Positive Airway Pressure group(BiPAP). BiPAP settings at 15/5 cm H2O by face mask with background rate 10 to 15/min. Standard steroid dose plus hourly salbutamol and oxygen to keep SaO2 > 92%.
arm group label: Non-invasive ventilation (CPAP).
arm group type: Experimental
description: Continuous Positive Airway Pressure group (CPAP). CPAP settings at 8 to 10 cm H2O. Standard steroid dose plus hourly salbutamol and oxygen to keep SaO2 > 92%.
arm group label: Non-invasive ventilation (BiPAP)
arm group type: Experimental
description: Standard steroid dose, hourly salbutamol, oxygen as needed, nebulized ipratropium q 6 hrly, magnesium sulfate 50 mg/kg IV (4 doses q 6 hrly), loading dose of aminophylline 6 mg/kg IV if no progress.
intervention type: Device
intervention name: BiPAP
description: The patient's breathing is assisted by cycling between high and low pressures at a pre-set rate.
arm group label: Non-invasive ventilation (BiPAP)
other name: Trilogy BiPAP
other name: Bilevel Positive Airway Pressure
intervention type: Device
intervention name: CPAP
description: The patient breathes against a constant pressure delivered by face mask.
arm group label: Non-invasive ventilation (CPAP).
other name: Continuous Positive Airway Pressure
intervention type: Drug
intervention name: Ipratropium
description: Nebulized q6h
arm group label: Conventional asthma therapy.
intervention type: Drug
intervention name: Magnesium Sulfate
description: 50mg/kg IV, 4 doses q6h
arm group label: Conventional asthma therapy.
intervention type: Drug
intervention name: Aminophylline
description: 6mg/kg IV (if no progress)
arm group label: Conventional asthma therapy.
intervention type: Drug
intervention name: Standard steroid dose, hourly salbutamol, oxygen as needed
description: Standard common therapies for all three arms.
arm group label: Conventional asthma therapy.
arm group label: Non-invasive ventilation (BiPAP)
arm group label: Non-invasive ventilation (CPAP).
criteria: 
gender: All
minimum age: 2 Years
maximum age: 18 Years
healthy volunteers: No
last name: Michael Seear
role: Principal Investigator
affiliation: University of British Columbia
last name: Michael Seear, MD
phone: 6048752000
email: mseear@cw.bc.ca
last name: Terry Viczko
phone: 6048752345
phone ext: 5419
email: tviczko@bcchr.ca
citation: Gowraiah V, Awasthi S, Kapoor R, Sahana D, Venkatesh P, Gangadhar B, Awasthi A, Verma A, Pai N, Seear M. Can we distinguish pneumonia from wheezy diseases in tachypnoeic children under low-resource conditions? A prospective observational study in four Indian hospitals. Arch Dis Child. 2014 Oct;99(10):899-906. doi: 10.1136/archdischild-2013-305740. Epub 2014 Jun 12.
PMID: 24925892
citation: Basnet S, Mander G, Andoh J, Klaska H, Verhulst S, Koirala J. Safety, efficacy, and tolerability of early initiation of noninvasive positive pressure ventilation in pediatric patients admitted with status asthmaticus: a pilot study. Pediatr Crit Care Med. 2012 Jul;13(4):393-8. doi: 10.1097/PCC.0b013e318238b07a.
PMID: 22067982
citation: Ducharme FM, Chalut D, Plotnick L, Savdie C, Kudirka D, Zhang X, Meng L, McGillivray D. The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers. J Pediatr. 2008 Apr;152(4):476-80, 480.e1. doi: 10.1016/j.jpeds.2007.08.034. Epub 2007 Oct 31.
PMID: 18346499
citation: Martinez FD, Vercelli D. Asthma. Lancet. 2013 Oct 19;382(9901):1360-72. doi: 10.1016/S0140-6736(13)61536-6. Epub 2013 Sep 13.
PMID: 24041942
citation: Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet. 2009 Jul 18;374(9685):250-9. doi: 10.1016/S0140-6736(09)60496-7.
PMID: 19616722
citation: British Thoracic Society Standards of Care Committee. Non-invasive ventilation in acute respiratory failure. Thorax. 2002 Mar;57(3):192-211. doi: 10.1136/thorax.57.3.192. No abstract available.
PMID: 11867822
citation: Nievas IF, Anand KJ. Severe acute asthma exacerbation in children: a stepwise approach for escalating therapy in a pediatric intensive care unit. J Pediatr Pharmacol Ther. 2013 Apr;18(2):88-104. doi: 10.5863/1551-6776-18.2.88.
PMID: 23798903
citation: Papiris SA, Manali ED, Kolilekas L, Triantafillidou C, Tsangaris I. Acute severe asthma: new approaches to assessment and treatment. Drugs. 2009;69(17):2363-91. doi: 10.2165/11319930-000000000-00000.
PMID: 19911854
citation: Green E, Jain P, Bernoth M. Noninvasive ventilation for acute exacerbations of asthma: A systematic review of the literature. Aust Crit Care. 2017 Nov;30(6):289-297. doi: 10.1016/j.aucc.2017.01.003. Epub 2017 Jan 27.
PMID: 28139368
citation: Soroksky A, Klinowski E, Ilgyev E, Mizrachi A, Miller A, Ben Yehuda TM, Shpirer I, Leonov Y. Noninvasive positive pressure ventilation in acute asthmatic attack. Eur Respir Rev. 2010 Mar;19(115):39-45. doi: 10.1183/09059180.00006109.
PMID: 20956164
responsible party type: Principal Investigator
investigator affiliation: University of British Columbia
investigator full name: Michael Seear
investigator title: Principal Investigator
mesh term: Asthma
mesh term: Magnesium Sulfate
mesh term: Aminophylline
mesh term: Albuterol
mesh term: Ipratropium
sharing ipd: No
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