Noninvasive ventilation in acute cardiogenic pulmonary edema.

Gray A, Goodacre S, Newby DE, Masson M, Sampson F, Nicholl J

This large multicenter, randomized, controlled trial set out to establish whether; noninvasive ventilation (continuous positive airway pressure (CPAP) or noninvasive intermittent positive-pressure ventilation (NIPPV)) reduces mortality and if there are important differences in outcome associated with the method of treatment, in a group of patients with acute cardiogenic pulmonary oedema.

Their findings included no significant difference in; 7-day mortality between patients receiving standard oxygen therapy and those undergoing noninvasive ventilation, or in the combined end point of death or intubation within 7 days between the two groups of patients undergoing noninvasive ventilation. Noninvasive ventilation was associated with greater mean improvements at 1 hour after the beginning of treatment in patient-reported dyspnea, heart rate, acidosis and hypercapnia. There were no treatment-related adverse events.

New England Journal of Medicine 2008; 359: 142-51.

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Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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