Noninvasive ventilation in patients with acute cardiogenic pulmonary edema

Sangeeta Mehta, Abdul Hakeem Al-Hashim, Sean P. Keenan

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)186-195
Number of pages10
JournalRespiratory Care
Volume54
Issue number2
Publication statusPublished - Feb 2009

Keywords

  • Acute cardiogenic pulmonary edema
  • Bi-level positive airway pressure
  • BiPAP respiratory failure
  • Congestive heart failure
  • Continuous positive airway pressure
  • CPAP
  • Mechanical ventilation
  • Noninvasive ventilation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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