Non-invasive ventilation in acute cardiogenic pulmonary oedema

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 ventilati...

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Bibliographic Details
Published in:Postgraduate Medical Journal 2005-10, Vol.81 (960), p.637-643
Main Authors: Agarwal, R, Aggarwal, A N, Gupta, D, Jindal, S K
Format: Article
Language:English
Subjects:
Acute Disease
bilevel positive airway pressure
Biological and medical sciences
BiPAP
cardiogenic
cardiogenic pulmonary oedema
Clinical trials
continuous positive airway pressure
Continuous Positive Airway Pressure - methods
CPAP
CPO
Decision Making
EPAP
Evidence-Based Medicine
expiratory positive airway pressure
General aspects
Heart
Hospitals
Humans
inspiratory positive airway pressure
Intermittent Positive-Pressure Ventilation - methods
Intubation
IPAP
Lungs
Mechanics
Medical prognosis
Medical sciences
Mortality
NIV
non-invasive ventilation
Pulmonary Edema - therapy
Pulmonary Gas Exchange
pulmonary oedema
Randomized Controlled Trials as Topic
Respiratory therapy
Review
Ventilation
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Summary: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.
ISSN:0032-5473
1469-0756
DOI:10.1136/pgmj.2004.031229