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Is the flow-safe disposable continuous positive airway pressure (CPAP) system as effective as non-invasive mechanical ventilation (NIMV) in the treatment of acute cardiogenic pulmonary Oedema?

Published:January 18, 2020DOI:https://doi.org/10.1016/j.ajem.2020.01.034
      Acute cardiogenic pulmonary oedema (ACPO) is one of the common causes of acute respiratory failure, constituting 10%–20% of acute heart failure syndromes and potentially causing death [
      • Nieminen M.S.
      • Brutsaert D.
      • Dickstein K.
      • Drexler H.
      • Follath F.
      • Harjola V.-P.
      • et al.
      EuroHeart failure survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population.
      ]. Acute cardiogenic pulmonary oedema usually presents with sudden dyspnoea at rest, impaired exertion capacity, tachypnoea, tachycardia and hypoxia. Increased endogenous catecholamine levels and hypertension due to stress are common in cases with good left ventricular function. Cough is a frequent finding in these cases. In the presence of severe oedema, patients may produce foamy or pink sputum. In these patients, the primary goal is to ensure adequate tissue oxygenation in order to prevent organ dysfunction and multiple organ failure [
      • Ingbar David H.
      Cardiogenic pulmonary edema: mechanisms and treatment-an intensivist's view.
      ].
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      References

        • Nieminen M.S.
        • Brutsaert D.
        • Dickstein K.
        • Drexler H.
        • Follath F.
        • Harjola V.-P.
        • et al.
        EuroHeart failure survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population.
        Eur Heart J. 2006; 27: 2725-2736https://doi.org/10.1093/eurheartj/ehl193
        • Ingbar David H.
        Cardiogenic pulmonary edema: mechanisms and treatment-an intensivist's view.
        Curr Opin Crit Care. 2019; 25: 371-378https://doi.org/10.1097/mcc.0000000000000626
        • Ponikowski P.
        • Voors A.A.
        • Anker S.D.
        • Bueno H.
        • Cleland J.G.F.
        • Coats A.J.S.
        • et al.
        ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the heart failure association (HFA) of the ESC.
        European Journal of Heart Failure, 2016. 2016; 18: 891-975https://doi.org/10.1002/ejhf.592
        • Ezekowitz J.A.
        • O'Meara E.
        • McDonald M.A.
        • Abrams H.
        • Chan M.
        • Ducharme A.
        • et al.
        2017 comprehensive update of the Canadian cardiovascular society guidelines for the management of heart failure.
        Can J Cardiol. 2017; 33: 1342-1433https://doi.org/10.1016/j.cjca.2017.08.022
      1. Weng, C-L, Zhao Y-T, Liu Q-H, Fu C-J, Sun F, Ma Y-L, Chen Y-W, He, Q -Y Meta-analysis: noninvasive ventilation in acute cardiogenic pulmonary edema. Ann Intern Med, 2010; 152(9): 590–600. doi:https://doi.org/10.7326/0003-4819-152-9-201005040-00009.

        • Masip J.
        • Peacock W.F.
        • Price S.
        • Cullen L.
        • Martin-Sanchez F.J.
        • Seferovic P.
        • et al.
        Acute heart failure study Group of the Acute Cardiovascular Care Association and the committee on acute heart failure of the heart failure Association of the European Society of cardiology, indications and practical approach to non-invasive ventilation in acute heart failure.
        Eur Heart J. 2017; 39: 17-25https://doi.org/10.1093/eurheartj/ehx580
        • Sun T.
        • Wan Y.
        • Kan Q.
        • Yang F.
        • Yao H.
        • Guan F.
        Zhang j, li L efficacy of noninvasive ventilation on in-hospital mortality in patients with acute cardiogenic pulmonary edema: a meta-analysis. In:Chinese.
        J Cardiol. 2014; 42: 161-168https://doi.org/10.3760/cma.j.issn.0253-3758.2014.02.013
        • Bellani G.
        • Foti G.
        • Spagnolli E.
        • Castagna L.
        • Patroniti N.
        • Pesenti A.
        An improved Boussignac device for the delivery of non-invasive CPAP: the SUPER-Boussignac.
        Intensive Care Med. 2009; 35: 1094-1099https://doi.org/10.1007/s00134-009-1403-x
        • Kendrick K.R.
        Can a self-rating 0-10 scale for dyspnea yield a common language that is understood by ED nurses, patients, and their families?.
        J Emerg Nurs. 2000; 26: 233-234https://doi.org/10.1016/S0099-1767(00)90095-3
        • Killip T.
        • Kimball J.T.
        Treatment of myocardial infarction in a coronary care unit: a two year experience with 250 patients.
        Am J Cardiol. 1967; 20: 457-464https://doi.org/10.1016/0002-9149(67)90023-9
        • Brusasco C.
        • Corradi F.
        • De Ferrari A.
        • Ball L.
        • Kacmarek R.M.
        • Pelosi P.
        CPAP devices for emergency prehospital use: a bench study.
        Respir Care. 2015; 60: 1777-1785https://doi.org/10.4187/respcare.04134
        • Spijker E.E.
        • de Bont M.
        • Bax M.
        • Sandel M.
        Practical use, effects and complications of prehospital treatment of acute cardiogenic pulmonary edema using the Boussignac CPAP system.
        International Journal Of Emergency Medicine. 2013; 6: 8https://doi.org/10.1186/1865-1380-6-8
        • Dieperink W.
        • Jaarsma T.
        • Van der Horst I.C.
        • Nieuwland W.
        • Vermeulen K.M.
        • Rosman H.
        • et al.
        Boussignac continuous positive airway pressure for the management of acute cardiogenic pulmonary edema: prospective study with a retrospective control group.
        BMC Cardiovasc Disord. 2007; 7: 40https://doi.org/10.1186/1471-2261-7-40