Non-invasive pressure support ventilation and CPAP in cardiogenic pulmonary edema: a multicenter randomized study in the emergency department

Nouira, Semir; Boukef, Riadh; Bouida, Wahid; Kerkeni, Wieme; Beltaïef, Kaouthar; Boubaker, Hamdi; Boudhib, Latifa; Grissa, Mohamed Habib; Trimech, Mohamed Naceur; Benzarti, M.; Methamem, Mehdi; Marghli, Soudani; Ltaief, Mondher

doi:10.1007/s00134-010-2082-3

Cited by 69 publications

(56 citation statements)

References 25 publications

(32 reference statements)

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“…(13) Nouira et al (11) observed similar effects of BiPAP use compared to CPAP on EI outcomes. Nonetheless, BiPAP is associated with faster improvements in respiratory failure in APE patients.…”

Section: Discussionmentioning

confidence: 92%

“…(10) The main indications for NIV are associated with chronic obstructive pulmonary disease (COPD) exacerbation and acute cardiogenic pulmonary edema (APE). (4,(11)(12)(13)(14) The main contraindications include a decreased level of consciousness, psychomotor agitation, hemodynamic instability, obstruction and trauma of the upper airway and undrained pneumothorax. (1,8) The most discussed NIV methods include continuous positive airway pressure (CPAP), which uses a single pressure level during both phases of the respiratory cycle, and ventilation with two levels of pressure (BiPAP -bi-level positive airway pressure), which uses an inspiratory positive airway pressure (IPAP) and an expiratory positive airway pressure (EPAP).…”

Section: Introductionmentioning

confidence: 99%

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Utilização da ventilação não invasiva em edema agudo de pulmão e exacerbação da doença pulmonar obstrutiva crônica na emergência: preditores de insucesso

Passarini

Zambon

Morcillo³

et al. 2012

Rev. bras. ter. intensiva

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Use of non-invasive ventilation in acute pulmonary ABSTRACTObjective: This study analyzed acute respiratory failure caused by acute pulmonary edema, as well as chronic obstructive pulmonary disease exacerbation, that was treated with non-invasive mechanical ventilation to identify the factors that are associated with the success or failure non-invasive mechanical ventilation in urgent and emergency service.Methods: This study was a prospective, descriptive and analytical study. We included patients of both genders aged ≥18 years who used noninvasive mechanical ventilation due to acute respiratory failure that was secondary to acute pulmonary edema or chronic obstructive pulmonary disease exacerbation. Patients with acute respiratory failure that was secondary to pathologies other than acute pulmonary edema and chronic obstructive pulmonary disease or who presented with contraindications for the technique were excluded. Expiratory pressures between 5 and 8 cmH 2 O and inspiratory pressures between 10 and 12 cmH 2 O were used. Supplemental oxygen maintained peripheral oxygen saturation at >90%. The primary outcome was endotracheal intubation.Results: A total of 152 patients were included. The median non-invasive mechanical ventilation time was 6 hours (range 1 -32 hours) for chronic obstructive

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Utilização da ventilação não invasiva em edema agudo de pulmão e exacerbação da doença pulmonar obstrutiva crônica na emergência: preditores de insucesso

Passarini

Zambon

Morcillo³

et al. 2012

Rev. bras. ter. intensiva

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“…In a comparison of CPAP with Bi-PAP, the latter demonstrated more rapid recovery of respiratory and hemodynamic parameters [19], but Bi-PAP associated with an increased incidence of acute myocardial infarction [14]. Recently, Nouira et al, [20] showed that Bi-PAP improves respiratory failure, while, Masip et al, [21] showed a decrease in intubation rate in Bi-PAP group when compared with CPAP. However, other studies [10,22] failed to demonstrate significant differences in vital signs, blood gases, and rate of myocardial infarction between two modes of ventilations and between Bi-PAPA and oxygen therapy [23].…”

Section: Introductionmentioning

confidence: 98%

Bi-level Versus Continuous Positive Airway Pressure in Acute Cardiogenic Pulmonary Edema: A Randomized Control Trial

El-Refay¹

2015

CMR

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Abstract:This study was to compare the efficacy of continuous, bi-level positive airway pressure (CPAP, Bi-PAP) and oxygen therapy on detailed observation of time-course change in blood gases, physiological parameters and rate of endotracheal intubation in patient with acute cardiogenic pulmonary edema (ACPE). Sixty-six patients with ACPE were randomly assigned to receive standard oxygen (O 2 ) therapy (n=23), CPAP (n=21), and Bi-PAP (n=22). Blood gases (PaCO 2 , PaO 2 , SaO 2 , pH, and HCO 3 ), and physiological parameters (HR, RR, SBP, and DBP) were collected at baseline (T0), immediately after 60 minutes (T60), and after 30 minutes of discontinuation (T90). A significant improvements (p<0.05) in PaCO 2 , PaO 2 , SaO 2 and vital signs were observed immediately after CPAP and Bi-PAP when compared to O 2 therapy. After 30 minutes of disconnection, Bi-PAP revealed significant improvement (p<0.05) in PaO 2 , SaO 2 , and respiratory rate. No differences on intubation and death rate detected among treatment groups. Both methods of noninvasive ventilations are effective treatment for ACPE. However, Bi-PAP should be considered as first line of treatment due to faster and continuous improvement in oxygenation and respiratory rate.

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“…In this issue of intensive care medicine, Nouira and colleagues [30] reported the results of another prospective, multicenter, randomized trial comparing the use of NIPPSV versus CPAP during the emergency care of CPE. The study was very well performed and the patients were carefully screened and selected.…”

mentioning

confidence: 99%

“…Taking into account previous literature and the new data provided by Nouira et al [30], what conclusions can be drawn from a clinical point of view? First, the use of NIV during acute respiratory distress is still an issue of importance.…”

mentioning

confidence: 99%

Is the noninvasive ventilatory mode of importance during cardiogenic pulmonary edema?

L’Her

2010

Intensive Care Med

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Non-invasive pressure support ventilation and CPAP in cardiogenic pulmonary edema: a multicenter randomized study in the emergency department

Abstract: During CPE, NIPSV accelerates the improvement of respiratory failure compared to CPAP but does not affect primary clinical outcome either in overall population or in subgroups of patients with hypercapnia or those with high B-type natriuretic peptide.

Cited by 69 publications

References 25 publications

Utilização da ventilação não invasiva em edema agudo de pulmão e exacerbação da doença pulmonar obstrutiva crônica na emergência: preditores de insucesso

Utilização da ventilação não invasiva em edema agudo de pulmão e exacerbação da doença pulmonar obstrutiva crônica na emergência: preditores de insucesso

Bi-level Versus Continuous Positive Airway Pressure in Acute Cardiogenic Pulmonary Edema: A Randomized Control Trial

Is the noninvasive ventilatory mode of importance during cardiogenic pulmonary edema?

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