Comparative analysis on Non-Ventilatory Managements in Acute Asthma

Abstract

Introduction: Acute asthma attacks, also known as acute asthma, are periods of escalating shortness of breath, cough, wheezing, chest tightness, or a combination of these symptoms. The bronchial tubes, which allow air to pass through the lungs, become irritated, inflamed, and obstructed. The majority of exacerbations are managed in an outpatient environment. In 2004, there were 14.7 million visits to doctor's offices and clinic outpatient divisions in the United States for acute asthma. A scoring rubric called the Young Respiratory Assessment Measure (PRAM) was developed for pediatric patients to assess the severity of their acute asthma using a combination of scalene muscle compression, suprasternal withdrawals, wheezing, air admission, and oxygen saturation. In comparison to intubation and intrusive ventilation, noninvasive ventilation has a many advantages. The most advantageous points is that the complication like throat soreness, arrhythmia, bleeding, mucosal damage, damage to other organs like thyroid, etc can be avoided.

Aims and Objectives: The study intended to compared the efficiency of using oxygen inhalation and rapid-acting bronchodilator as first line management of acute exacerbant asthma.

Materials and Methods: The study design is retrospective cross-sectional which was conducted during the period of 7 months. The study has considered 100 patients, among which 45 patients are male and 55 patients are female. The patients who visited the Emergency Department were considered.  The patients on arrival to the emergency department was assessed for PRAM score (Initial PRAM score) and was interpreted. Then either oxygen or Short-Acting Beta Agonist (Salbutamol) inhalation was given. Then again, after a fixed interval, the patient’s PRAM score was assessed (Post-Interventional PRAM score). PRAM score was assessed and interpreted.

Result: The study found that, after intervention, Group 1 achieved PRAM score of 4.48±1.41 in Group 1 (Oxygen group) while Group 2 (Short-Acting Beta Agonist inhalation) achieved 6.12±1.47.  It was found that in patients of Group 1, the mean of changes in all the patients was 6 while in the patients of Group 2 was 4.18.

Conclusion: The study concludes that the acute asthmatic episode in emergency department can be managed by oxygen inhalation better than Short-Acting Beta Agonist inhalation. Oxygen inhalation is easier to give as compared to intubation and is also efficient in lowering PRAM score and hence, evidently showed the efficacy for proper management of severe acute asthma in emergency setting.

Keywords: pram, acute asthma, oxygen, salbutamol, non-ventilatory