For wheezing or bronchospasm, which additional ventilation strategy may be considered?

• A. Nebulized albuterol
• B. IV furosemide
• C. Oral steroids
• D. CPAP/BiPAP

Answer: (D)

Noninvasive positive-pressure ventilation can be considered in wheezing or bronchospasm when the patient has significant work of breathing or hypoxemia and can protect their airway. Delivering CPAP or BiPAP provides a steady or bilevel airway pressure that keeps airways open during expiration, increases functional residual capacity, and improves alveolar ventilation. This helps oxygenation and reduces the work of breathing without needing intubation, making it a helpful adjunct when bronchodilators and steroids alone aren’t enough and the patient is cooperative and stable enough for noninvasive support. Use with caution in cases of hypotension, altered mental status, inability to protect the airway, vomiting, facial trauma, or suspected pneumothorax. The other options are pharmacologic treatments rather than ventilation strategies, so they don’t provide the same ventilation support.