Paediatric anaesthesia & critical care
Bilevel Positive Airway Pressure and Continuous Albuterol for Pediatric Asthma Exacerbations: A Randomized Clinical Trial
Primary result · Duration of continuous albuterolResult — go to the resultMean difference −0.5 hours 95% CI −5.0 to 4.1- Stopped at 50% interim analysis for meeting a priori futility bounds
Authors' conclusion
In this randomized clinical trial of early initiation of BPAP in the ED, no clinically significant decrease in the duration of continuous β-agonist therapy in pediatric patients presenting with moderate asthma exacerbations was observed.
Study context
- Population
- Children 5–17 years in a quaternary pediatric emergency department (ED) with acute asthma exacerbation (pediatric respiratory assessment measure ≥4, moderate) prescribed continuous albuterolprimary analysis
- Participants
- Sixty-six children
- Comparison
- Bilevel positive airway pressure (BPAP) vs sham BPAP for 4 hours, with continuous albuterol
- Primary endpoint
- Duration of continuous albuterol therapy
Methodological detailsdouble-blind, sham-controlled, single-centre, sequential design with planned interim analysis for futility and superiority
- Double-blind
- Sham-controlled
- Single-centre
- Sequential design with planned interim analysis for futility and superiority
Primary result
Duration of continuous albuterol
Mean difference
−0.5 hours
95% CI −5.0 to 4.1
P = 0.84
By group
BPAP vs Sham BPAP
mean difference −0.5 hours (95% CI −5.0 to 4.1); P = 0.84
As reported in the abstract
Further findings
Events
| Outcome | BPAP | Sham BPAP |
|---|---|---|
| Death, invasive mechanical ventilation, air leak syndrome, aspiration pneumonia | 0 | 0 |
Original publication
Bilevel Positive Airway Pressure and Continuous Albuterol for Pediatric Asthma Exacerbations: A Randomized Clinical Trial. JAMA Netw Open. Published 3 August 2026. doi:10.
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