RT Journal Article SR Electronic T1 Noninvasive positive pressure ventilation in acute asthmatic attack JF European Respiratory Review JO EUROPEAN RESPIRATORY REVIEW FD European Respiratory Society SP 39 OP 45 DO 10.1183/09059180.00006109 VO 19 IS 115 A1 Soroksky, A. A1 Klinowski, E. A1 Ilgyev, E. A1 Mizrachi, A. A1 Miller, A. A1 Ben Yehuda, T. M. A1 Shpirer, I. A1 Leonov, Y. YR 2010 UL http://err.ersjournals.com/content/19/115/39.abstract AB Asthma is characterised by reversible airway obstruction. In most patients, control of disease activity is easily achieved. However, in a small minority, asthma may be fatal. Between the two extremes lie patients with severe asthmatic attacks, refractory to standard treatment. These patients are at an increased risk of recurrent severe attacks, with respiratory failure, and mechanical ventilation. Invasive mechanical ventilation of the asthmatic patient is associated with a higher risk of complications and, therefore, is a measure of last resort. Noninvasive positive pressure ventilation (NPPV) is another treatment modality that may be beneficial in patients with severe asthmatic attack who are at an increased risk of developing respiratory failure. These patients have the potential to benefit from early respiratory support in the form of NPPV. However, reports of NPPV in asthmatic patients are scarce, and its usage in asthmatic attacks is, therefore, still controversial. Only a few reports of NPPV in asthma have been published over the last decade. These studies mostly involve small numbers of patients and those who have problematic methodology. In this article we review the available evidence for NPPV in asthma and try to formulate our recommendations for NPPV application in asthma based on the available evidence and reports.