Noninvasive Ventilation in Pulmonary Edema

CPAP and NIPPV improve symptoms but do not alter death rates compared with standard oxygen therapy.

The widely held belief that noninvasive ventilation is beneficial in patients with acute pulmonary edema is based on studies that were either not randomized or too small to show unequivocal outcome effects, particularly with respect to mortality. In a multicenter study from the U.K., investigators randomized 1156 emergency department patients with acute pulmonary edema to one of three treatments: standard oxygen therapy, continuous positive airway pressure (CPAP), or noninvasive intermittent positive pressure ventilation (NIPPV, also called bilevel positive airway pressure; JW Emerg Med Mar 3 2004).

In all groups, oxygen was delivered to maintain peripheral oxyhemoglobin saturation above 92%. CPAP was started at 5 cm water and was increased …

Reviewing Author

J. Stephen Bohan, MD, MS, FACP, FACEP

Disclosures

RoyaltiesKlint Law Firm

Editorial boardsCritical Decisions in Emergency Medicine

J. Stephen Bohan, MD, MS, FACP, FACEP

Disclosures

RoyaltiesKlint Law Firm

Editorial boardsCritical Decisions in Emergency Medicine