Skip to main content

BiPAP for treating moderate and severe asthma exacerbations in a PED


BiPAP utilization for the treatment of severe refractory status asthmaticus patients has become an accepted therapy but is not well described for moderate exacerbations. We sought to analyze outcomes from our BiPAP quality database for children presenting in status asthmaticus at varying levels of severity.


PED status asthmaticus patients requiring BiPAP from 1 January 2010 to 31 August 2012 had a bedside interview and documentation of information at the time therapies were given. Incomplete data were collected retrospectively. All data were stored and analyzed using a RedCap database. Subjects were stratified into severity groups based on asthma score at the time of BiPAP placement.


There were 206 subjects in the moderate severity group and 197 in the severe group. Table 1 shows the groups were well matched and compares other pertinent data. Children with severe presentations were placed on BiPAP sooner (P < 0.001) and remained on BiPAP longer (P < 0.001). The moderate group had a longer wait until BiPAP placement. Tables 2 and 3 demonstrate higher initial BiPAP (IPAP/EPAP) settings with increasing age and severity. Figure 1 trends initiation and termination asthma scores stratified by severity at BiPAP placement. More of the severe group was admitted to the PICU andhad overall longer hospitalizations (P < 0.06). None experienced severe complications.

Table 1 Comparison of children receiving BiPAP for status asthmaticus by severity of illness
Table 2 Mean settings by age: moderate group
Table 3 Mean settings by age: severe group
Figure 1

Initiation and termination asthma scores grouped by severity.


BiPAP is a benefi cial therapy for children presenting to the PED with severe asthma exacerbations. It may have utility for less severe asthma exacerbations.

Author information



Corresponding author

Correspondence to A Williams.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Williams, A., Abramo, T. BiPAP for treating moderate and severe asthma exacerbations in a PED. Crit Care 17, P266 (2013).

Download citation


  • Asthma
  • Severe Group
  • Refractory Status
  • Status Asthmaticus
  • Pertinent Data