Noninvasive Ventilation for Cardiogenic Pulmonary Edema

A meta-analysis documented an in-hospital survival benefit of noninvasive positive-pressure ventilation over standard therapy.

In patients with acute cardiogenic pulmonary edema, noninvasive positive-pressure ventilation (NIPPV) outperforms standard therapy (face-mask oxygen, diuretics, nitrates, and other supportive care) in reducing the need for invasive mechanical ventilation. To assess NIPPV’s effectiveness on other endpoints, including in-hospital mortality, researchers conducted a meta-analysis of 23 randomized trials of NIPPV versus standard care. NIPPV support can be provided by continuous positive airway pressure (CPAP) or by bilevel (inspiratory and expiratory) ventilation.

Compared with standard therapy, CPAP was associated with significantly lower risk for in-hospital mortality (relative risk, 0.59; P=0.015) and bilevel ventilation with a trend toward lo…

Reviewing Author

Beat J. Meyer, MD