Noninvasive Positive Airway Pressure and Risk of Myocardial Infarction in Acute Cardiogenic Pulmonary Edema: Continuous Positive Airway Pressure vs Noninvasive Positive Pressure Ventilation

Ferrari G, Olliveri F, De Filippi G, Milan A, Aprà F, Boccuzzi A, Converso M, Navalesi P

The use of positive pressure ventilation in patients with acute respiratory failure secondary to acute cardiogenic pulmonary oedema (ACPE) is known to have both haemodymamic and respiratory effects. This study set out to determine whether the application of noninvasive positive pressure ventilation (n-IPPV), as opposed to noninvasive continuous positive airway pressure (n-CPAP) increased the rate of acute myocardial infarction in acute cardiogenic pulmonary oedema patients. It also compared the two techniques with respect to rate of intubation, death, duration of ventilatory assistance and length of hospital stay.

The results indicate that n-IPPV and n-CPAP are equally effective in treating patients with acute respiratory failure secondary to ACPE and that the rate of acute myocardial infarction is not different between the two techniques. There was a trend towards a faster reduction in PaCO2 in the n-IPPV group in the hypercapnic patients.

Chest 2007; 132 (6): 1804 – 1809

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