Journal Article

An Updated Review on the Use of Noninvasive Respiratory Supports in the Management of Severe Asthma Exacerbations

Paternò, Daniele Salvatore, La Via, Luigi, Pappalardo, Federico, Piattoli, Matteo, Misseri, Giovanni, Cuttone, Giuseppe, Gregoretti, Cesare, Sorbello, Massimiliano

2025

Overview

Asthma is a reversible clinical condition characterized by airway obstruction due to bronchial smooth muscle contraction, inflammation and a hypersecretive state. Severe asthma exacerbations (SAE) may be a part of the natural history of this condition. Patients presenting with SAE are at higher risk of recurrent attacks, often nonresponsive to medical therapy and eventually requiring invasive mechanical ventilation (MV). The use of noninvasive respiratory supports (NRSs) may be beneficial in patients with SAE who are at risk of developing acute respiratory failure (ARF). However, their application is insufficiently supported by the evidence, as reports on their application in asthmatic patients are scarce and only a few retrospective studies with a limited number of participants have been published to date. This review discusses the potentialities of NRS in the treatment of SAE, with reference to the pathophysiological background and future perspectives on their use in asthma management.

• Publisher: MDPI AG,MDPI
• Subject: Acute respiratory distress syndrome / acute respiratory failure / Airway management / ARF / Asthma / Asthma - complications / Asthma - physiopathology / Asthma - therapy / Bronchodilators / Continuous positive airway pressure / CPAP / Disease Progression / Dyspnea / Hemodynamics / HFNOT / high flow nasal cannula / Humans / Hypoxemia / Inflammation / Mortality / Noninvasive Ventilation - methods / Pathophysiology / Respiratory failure / Respiratory Insufficiency - etiology / Respiratory system / Review / Ventilators