Non-invasive ventilation in acute cardiogenic pulmonary oedema

R Agarwal, A N Aggarwal, D Gupta, S K Jindal, R Agarwal, A N Aggarwal, D Gupta, S K Jindal

Abstract

Non-invasive ventilation (NIV) is the delivery of assisted mechanical ventilation to the lungs, without the use of an invasive endotracheal airway. NIV has revolutionised the management of patients with various forms of respiratory failure. It has decreased the need for invasive mechanical ventilation and its attendant complications. Cardiogenic pulmonary oedema (CPO) is a common medical emergency, and NIV has been shown to improve both physiological and clinical outcomes. From the data presented herein, it is clear that there is sufficiently high level evidence to favour the use of continuous positive airway pressure (CPAP), and that the use of CPAP in patients with CPO decreases intubation rate and improves survival (number needed to treat seven and eight respectively). However, there is insufficient evidence to recommend the use of bilevel positive airway pressure (BiPAP), probably the exception being patients with hypercapnic CPO. More trials are required to conclusively define the role of BiPAP in CPO.

References

    1. Respir Care. 2003 Oct;48(10):922-5
    1. Am J Respir Crit Care Med. 1996 May;153(5):1591-9
    1. Am J Respir Crit Care Med. 2003 Dec 15;168(12):1432-7
    1. Am J Respir Crit Care Med. 2003 Dec 15;168(12):1406-8
    1. Eur Respir J. 2004 Jan;23(1):129-35
    1. Chest. 2004 Feb;125(2):669-82
    1. Respir Care. 2004 Mar;49(3):270-5
    1. Emerg Med J. 2004 Mar;21(2):155-61
    1. Respiration. 2004 Mar-Apr;71(2):144-51
    1. Intensive Care Med. 2004 May;30(5):882-8
    1. Respir Care. 2004 Jul;49(7):810-29
    1. Crit Care Med. 2004 Sep;32(9):1860-5
    1. Ann Intern Med. 1972 Feb;76(2):173-84
    1. J Appl Physiol. 1975 Apr;38(4):681-7
    1. N Engl J Med. 1979 Aug 30;301(9):453-9
    1. J Appl Physiol Respir Environ Exerc Physiol. 1981 Aug;51(2):499-508
    1. Am Rev Respir Dis. 1982 Jul;126(1):9-13
    1. Intensive Care Med. 1983;9(1):17-9
    1. Am J Cardiol. 1985 Feb 1;55(4):296-300
    1. Chest. 1985 Oct;88(4):519-26
    1. Chest. 1987 Sep;92(3):481-5
    1. Chest. 1988 Mar;93(3):506-9
    1. J Appl Physiol (1985). 1988 Sep;65(3):1244-50
    1. Am Rev Respir Dis. 1988 Aug;138(2):355-61
    1. Circ Res. 1990 Jul;67(1):130-41
    1. J Formos Med Assoc. 1991 Aug;90(8):736-43
    1. N Engl J Med. 1991 Dec 26;325(26):1825-30
    1. Am Rev Respir Dis. 1992 Feb;145(2 Pt 1):377-82
    1. J Appl Physiol (1985). 1992 Aug;73(2):498-505
    1. Chest. 1992 Nov;102(5):1397-401
    1. Chest. 1993 Jan;103(1):143-50
    1. Chest. 1994 Jan;105(1):229-31
    1. Am J Respir Crit Care Med. 1994 May;149(5):1069-76
    1. Circulation. 1995 Mar 15;91(6):1725-31
    1. Am J Respir Crit Care Med. 1995 Apr;151(4):1126-35
    1. Crit Care Med. 2000 Jun;28(6):1785-90
    1. Chest. 1995 May;107(5):1379-86
    1. Am J Respir Crit Care Med. 1996 Jul;154(1):182-6
    1. Am J Respir Crit Care Med. 1997 Feb;155(2):500-5
    1. Crit Care Med. 1997 Apr;25(4):620-8
    1. Lancet. 1997 Jun 14;349(9067):1720-4
    1. Lancet. 1998 Feb 7;351(9100):389-93
    1. Jpn Circ J. 1998 Aug;62(8):553-8
    1. Chest. 1998 Oct;114(4):1185-92
    1. Intensive Care Med. 1999 Jan;25(1):21-8
    1. J Am Coll Cardiol. 2000 Sep;36(3):832-7
    1. Lancet. 2000 Dec 23-30;356(9248):2126-32
    1. Am J Respir Crit Care Med. 2001 Feb;163(2):540-77
    1. Arq Bras Cardiol. 2001 Mar;76(3):221-30
    1. J Emerg Med. 2001 Nov;21(4):363-9
    1. Am J Respir Crit Care Med. 2002 Jan 1;165(1):4-8
    1. Eur Respir J. 2002 Apr;19(4):712-21
    1. Eur J Heart Fail. 2002 Jun;4(3):227-34
    1. Eur Heart J. 2002 Sep;23(17):1379-86
    1. JAMA. 2002 Aug 28;288(8):932-5
    1. Crit Care Med. 2002 Nov;30(11):2457-61
    1. Crit Care Med. 2003 Feb;31(2):468-73
    1. Chest. 1999 Jul;116(1):166-71
    1. J Clin Invest. 1958 Jan;37(1):111-7
    1. Crit Care Med. 2004 Dec;32(12):2407-15
    1. Intensive Care Med. 2003 Nov;29(11):1921-8

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