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Intensive Care Medicine
Published in: Intensive Care Medicine 6/2005

01-06-2005 | Original

Noninvasive pressure support ventilation vs. continuous positive airway pressure in acute hypercapnic pulmonary edema

Authors: Andrea Bellone, Marco Vettorello, Alessandra Monari, Francesca Cortellaro, Daniele Coen

Published in: Intensive Care Medicine | Issue 6/2005

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Abstract

Objective

This study compared noninvasive pressure support ventilation (NIPSV) and continuous positive airway pressure (CPAP) in patients with acute hypercapnic pulmonary edema with regard to resolution time.

Design and setting

Randomized prospective study in an emergency department.

Patients and participants

We randomly assigned 36 patients with respiratory failure due to acute pulmonary edema and arterial hypercapnia (PaCO2 >45 mmHg) to NIPSV (n=18) or CPAP through a face mask (n=18).

Measurements and results

Electrocardiographic and physiological measurements were made over 36 h. There was no difference in resolution time defined as clinical improvement with a respiratory rate of fewer than 30 breaths/min and SpO2 of 96% or more between CPAP and NIPSV groups. Arterial carbon dioxide tension was significantly decreased after 1 h of ventilation (CPAP, 60.5±13.6 to 42.8±4.9 mmHg; NIPSV, 65.7±13.6 to 44.0±5.5 mmHg); respective improvements were seen in pH (CPAP, 7.22±0.11 to 7.37±0.04; NIPSV, 7.19±0.11 to 7.38±0.04), SpO2 (CPAP, 86.9±3.7% to 95.1±2.6%; NIPSV, 83.7±6.6% to 96.0±2.9%), and respiratory rate (CPAP, 37.9±4.5 to 21.3±5.1 breaths/min; NIPSV, 39.8±4.4 to 21.2±4.6 breaths/min). No significant differences were seen with regards to endotracheal intubation and in-hospital mortality.

Conclusions

NIPSV proved as effective as CPAP in the treatment of patients with acute pulmonary edema and hypercapnia but did not improve resolution time.
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Metadata
Title
Noninvasive pressure support ventilation vs. continuous positive airway pressure in acute hypercapnic pulmonary edema
Authors
Andrea Bellone
Marco Vettorello
Alessandra Monari
Francesca Cortellaro
Daniele Coen
Publication date
01-06-2005
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 6/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2649-6

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