Nocturnal CPAP in pediatric moderate-severe asthma does little

  • Praca E & al.
  • Respirology
  • 16 Nov 2018

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • 4 weeks of nocturnal continuous positive airway pressure (CPAP) does little to suppress airway reactivity or inflammation in children with moderate-severe asthma in this small clinical trial .

Why this matters

  • These authors had previously found an effect of 1 week of CPAP on airway reactivity in adults with mild asthma that was well-controlled.
  • These children also were using inhaled corticosteroids or systemic corticosteroids.

Key results

  • Although some improvement was seen, decreases in lower airway activity (PC20) were not significant within or between groups.
  • Adherence was about 70% in both groups.
  • The groups (sham vs real CPAP) also did not differ in asthma exacerbations requiring oral corticosteroid treatment.
  • The groups did not differ in sputum eosinophil counts or cytokine values.

Study design

  • Included children ages 8-17 years, moderate-severe asthma: 27 CPAP, 28 sham, for 4 weeks.
  • Airway reactivity assessed via methacholine bronchial challenge.
  • Funding: NIH.

Limitations

  • Small numbers, included only children with moderate-severe asthma, single-center.

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