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To exclude patients with concomitant diseases and/or those who were not suitable for NIV treatment, the following exclusion criteria were applied: (i) smoking history >10?years or history of COPD; (ii) known chronic pulmonary disease other than asthma; (iii) ETI for cardiopulmonary arrest; (iv) ETI this website of comatose patients (Glasgow coma scale 150 beats/min, or systolic blood pressure?>?90?mm?Hg; (vi) history of heart failure; (vii) pneumonia; (viii) lung cancer; (ix) pneumothorax or mediastinal emphysema; and (x) pregnancy. Finally, only patients who fulfilled at least two of the following criteria on arrival were included in the analysis: (i) required supplemental oxygen to maintain SaO2?>?90% or PaO2?>?60?mm?Hg; (ii) PaCO2?>?45?mm?Hg; (iii) respiratory rate >30 breaths/min; and (iv) use of respiratory accessory muscles. If the same patient was admitted more than twice with an asthma attack within 3?months, only the first event was Tariquidar mouse included in the analysis. Data analysis was performed only by the co-authors, and the use of all data was approved by the institutional review board. All patients underwent initial assessments that included a history, physical examination and CXR. Conventional medical treatments, such as inhaled ��2 agonists, intravenous corticosteroids and subcutaneous adrenaline were administered as required. If MV had already been applied or would be applied soon, patients were transferred to the intensive care unit (ICU) or the intermediate care unit in the emergency department. In all cases, a physician and other medical staff monitored patients closely, so that ETI could be performed promptly at any time. Although the decisions regarding ETI were based on clinical judgements, the following factors were considered to be indications for ETI: (i) unable to maintain SaO2?>?90% even with maximal supplementary oxygen (10�C15?L/min); (ii) hypercapnia and/or respiratory acidosis (PaCO2?>?55?mm?Hg and/or pH?GSK3B and fraction of inspired O2 (FiO2) was titrated so that SaO2?>?90%. Expiratory positive airway pressure was also adjusted so as to improve patient�Cventilator interaction by attenuating the inspiratory muscle effort required to trigger inspiration. If there were no signs of spontaneous failure of breathing or desaturation (SaO2?