TY - JOUR
T1 - Noninvasive ventilation in patients with acute cardiogenic pulmonary edema
AU - Mehta, Sangeeta
AU - Al-Hashim, Abdul Hakeem
AU - Keenan, Sean P.
PY - 2009/2
Y1 - 2009/2
N2 - Acute cardiogenic pulmonary edema (ACPE) is a common cause of respiratory failure that necessitates endotracheal intubation. In some patients intubation and its attendant complications can be avoided with noninvasive ventilation (NIV). Both continuous positive airway pressure (CPAP) and NIV have been evaluated in patients with ACPE. Compared to conventional treatment, both CPAP and NIV improve vital signs and physiologic variables, and reduce intubation rate, in patients with ACPE. Both CPAP and NIV appear to be well tolerated and are not associated with any serious adverse events. Initial concern that NIV may be associated with a greater risk of myocardial infarction than CPAP was laid to rest by later studies. Despite a physiologic rationale that NIV should offer greater benefit than CPAP, NIV has not been found to offer any advantages regarding intubation rate or mortality compared with CPAP. We review the randomized controlled trials and summarize the evidence on NIV and CPAP in patients with ACPE.
AB - Acute cardiogenic pulmonary edema (ACPE) is a common cause of respiratory failure that necessitates endotracheal intubation. In some patients intubation and its attendant complications can be avoided with noninvasive ventilation (NIV). Both continuous positive airway pressure (CPAP) and NIV have been evaluated in patients with ACPE. Compared to conventional treatment, both CPAP and NIV improve vital signs and physiologic variables, and reduce intubation rate, in patients with ACPE. Both CPAP and NIV appear to be well tolerated and are not associated with any serious adverse events. Initial concern that NIV may be associated with a greater risk of myocardial infarction than CPAP was laid to rest by later studies. Despite a physiologic rationale that NIV should offer greater benefit than CPAP, NIV has not been found to offer any advantages regarding intubation rate or mortality compared with CPAP. We review the randomized controlled trials and summarize the evidence on NIV and CPAP in patients with ACPE.
KW - Acute cardiogenic pulmonary edema
KW - Bi-level positive airway pressure
KW - BiPAP respiratory failure
KW - CPAP
KW - Congestive heart failure
KW - Continuous positive airway pressure
KW - Mechanical ventilation
KW - Noninvasive ventilation
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M3 - Article
C2 - 19173751
AN - SCOPUS:65549109070
SN - 0020-1324
VL - 54
SP - 186
EP - 195
JO - Respiratory Care
JF - Respiratory Care
IS - 2
ER -