Noninvasive ventilation in patients with acute cardiogenic pulmonary edema

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 bee...

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Bibliographic Details
Published inRespiratory care Vol. 54; no. 2; p. 186
Main Authors Mehta, Sangeeta, Al-Hashim, Abdul Hakeem, Keenan, Sean P
Format Journal Article
LanguageEnglish
Published United States 01.02.2009
Subjects
Continuous Positive Airway Pressure
Humans
Intubation, Intratracheal - adverse effects
Pulmonary Edema - therapy
Randomized Controlled Trials as Topic
Ventilators, Mechanical - adverse effects
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Summary: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.
ISSN:0020-1324