الفهرس 
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Abstract
Non- invasive ventilation functions to bridge the gap between maximal medical treatment and invasive mechanical ventilation in acute severe asthma patients.
• The results of this study suggested that the addition of noninvasive ventilation similar in efficacy to standard medical therapy in spirometric data as FEV1/FVC, and MEF 25-75. More than 50% improvement of FEV1 shows no significant difference in the group of patients with acute severe asthma using NIV and to those on conventional medical therapy.
• Favorable effects of NIV have been demonstrated in the improvement of clinical parameters as the grading of dyspnea and acceleration of the time needed for the absence of accessory muscle of respiration usage in acute severe asthma patients. NIV also had effectively corrected respiratory rate and heart rate after 6 hours.
• NIV has a Significant benefit in improving oxygenation with applying positive end-expiratory pressure (PEEP) than with conventional medical therapy alone, as it decreases the work of breathing, relieves fatigued muscles of respiration thus keeps the airway opened during expiration.
• Use of NIV is associated with lower intubation rate compared with conventional medical therapy so avoiding complications of endotracheal intubation.
• Length of hospital and ICU stay were significantly shorter with adding NIV to conventional medical therapy in acute severe asthma patients.
• The relative success of NIV in respiratory failure patients with hypercapnia compared to conventional medical therapy patients can be due to the more rapid reversible nature of the hypercapnic disease.
• There is now good evidence predictors for the noninvasive ventilation failure in acute severe asthma patients:
1. Increase duration of asthma
2. Previous history of ICU admission
3. Failure to improve oxygenation under NIV
4. Elevation of PaCO2 under NIV
5. Higher respiratory rate or heart rate under NIV
6.Use of accessory muscle of respiration