Non-invasive positive airway pressure ventilation and risk of myocardial infarction (MI) in acute cardiogenic pulmonary edema (ACPE): continuous positive airway pressure (CPAP) vs. non invasive positive pressure ventilation (NIV)

Ferrari, Giovanni; Filippi, Giovanna De; Milan, Alberto; Aprà, Franco; Pagnozzi, Fiammetta; Boccuzzi, Adriana; Molino, Paola; Olliveri, F.

doi:10.1016/j.jemermed.2006.02.040

Cited by 2 publications

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“…CPAP resulted in easier and less expensive application, and a meta-analysis suggests a greater efficacy in reducing mortality for this modality [51]. However, some studies [38,39] suggest that NPPV may be preferable for patients with persisting dyspnoea or hypercapnia after initiation of CPAP, whereas early concerns about possible greater risks of myocardial infarction with NPPV [38] were not confirmed [53]. The main physiological benefit of CPAP in these patients is related to decreased left ventricular pre-load and afterload owing to increased intrathoracic pressure, resulting in improved cardiac performance; an increase in functional residual capacity reopens collapsed alveoli and improves oxygenation.…”

Section: Acute Cardiogenic Pulmonary Oedemamentioning

confidence: 99%

Noninvasive positive pressure ventilation in the acute care setting: where are we?

Ambrosino¹,

Vagheggini²

2008

European Respiratory Journal

170

128

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Noninvasive positive pressure ventilation (NPPV) is a technique used to deliver mechanical ventilation that is increasingly utilised in acute and chronic conditions. The present review examines the evidence supporting the use of NPPV in acute respiratory failure (ARF) due to different conditions. Strong evidence supports the use of NPPV for ARF to prevent endotracheal intubation (ETI), as well as to facilitate extubation in patients with acute exacerbations of chronic obstructive pulmonary disease and to avoid ETI in acute cardiogenic pulmonary oedema, and in immunocompromised patients. Weaker evidence supports the use of NPPV for patients with ARF due to asthma exacerbations, with post-operative or post-extubation ARF, pneumonia, acute lung injury, acute respiratory distress syndrome, or during bronchoscopy. NPPV should be applied under close clinical and physiological monitoring for signs of treatment failure and, in such cases, ETI should be promptly available. A trained team, careful patient selection and optimal choice of devices can optimise outcome of NPPV.Noninvasive positive pressure ventilation is increasingly being used in the management of acute respiratory failure but caregivers must respect evidence-supported indications and avoid contraidincations. Additionally, the technique must be applied in the appropriate location by a trained team in order to avoid disappointing results.

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Section: Acute Cardiogenic Pulmonary Oedemamentioning

confidence: 99%

Noninvasive positive pressure ventilation in the acute care setting: where are we?

Ambrosino¹,

Vagheggini²

2008

European Respiratory Journal

170

128

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“…We therefore decided to compare the modi ed snorkeling mask with the Helmet and one of the most popular full face mask (PerforMax full face mask), during CPAP. We applied CPAP at 10 cmH 2 O because this is a value most commonly applied in this clinical setting 20,21 .…”

Section: Discussionmentioning

confidence: 99%

Comparative Bench Study Evaluation of a Modified Snorkeling Mask Used During COVID-19 Pandemia and Standard Interfaces for Non-invasive Ventilation.

Ferrone

Spinazzola

Costa

et al. 2020

Preprint

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BackgroundCOVID-19 infection has put enormous pressure on the healthcare systems worldwide and especially on Intensive Care Units (ICUs). In this particular situation, a modified snorkeling mask into a mask for non-invasive continuous positive airway pressure (nCPAP) and non-invasive ventilation (NIV), with the help of 3D printers, has been proposed for clinical use. We designed a bench study to compare a Helmet (H), a Full face mask (RFF) and a modified full face snorkeling mask (MFF) for delivering nCPAP and NIV in pressure support mode (PSV).MethodsA mannequin was connected to an active lung simulator. The inspiratory and expiratory variations in airways pressure observed with a high simulated effort (Pmus), were determined relative to the preset CPAP level. NIV was applied in PSV at two simulated respiratory rates and two cycling-off ﬂow thresholds. During the bench study we measured the variables defining patient-ventilator interaction and performance. ResultsDuring nCPAP, the MFF presented significantly lower values of ΔPawi and ∆Pawe compared to the other interfaces tested (H and RFF). During NIV, the MFF demonstrated a better patient-ventilator interaction compared to RFF, as shown by significantly shorter Timepress and Delaytrexp (p<0.01), but no significant differences were found in terms of Delaytrinsp and Timesync between the interfaces tested. At RR 20sim, the MFF presented the shorter ΔPtrigger (p<0.01), moreover during all the conditions tested the MFF showed the longer PTP 200, 300 and 500 compared to RFF (p<0.01). A major limitation of MFF is that during NIV with this interface it is possible to reach at maximum 18 cmH2O of peak inspiratory pressure. Over this pressure value, the presence of air leaks determined important asynchrony phenomena. For this reason, our test was limited to one pressure support and PEEP set (PS 10 cmH2O and PEEP 8 cmH2O).ConclusionsThe modified full face snorkeling mask can be used as an acceptable alternative to other interfaces for both nCPAP and NIV in emergency situations.

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Non-invasive positive airway pressure ventilation and risk of myocardial infarction (MI) in acute cardiogenic pulmonary edema (ACPE): continuous positive airway pressure (CPAP) vs. non invasive positive pressure ventilation (NIV)

Cited by 2 publications

References 0 publications

Noninvasive positive pressure ventilation in the acute care setting: where are we?

Noninvasive positive pressure ventilation in the acute care setting: where are we?

Comparative Bench Study Evaluation of a Modified Snorkeling Mask Used During COVID-19 Pandemia and Standard Interfaces for Non-invasive Ventilation.

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