For Heart Failure Exacerbation, It's Time to Vent (Noninvasively)

Noninvasive positive pressure ventilation prevents intubation and in-hospital mortality in patients with acute cardiogenic pulmonary edema.

For patients hospitalized with acute heart failure (HF) exacerbations and pulmonary edema, U.S. 2013 guidelines (Circulation 2013; 128:e240) and 2017 updates (Circulation 2017; 136:e137) do not address noninvasive ventilation (NIV), whereas European 2016 guidelines (Eur Heart J 2016 37:2129) recommend its prompt consideration. Investigators conducted a meta-analysis of 24 randomized, controlled trials that involved 2600 patients who presented to an emergency department or were inpatients; all had acute HF exacerbation with pulmonary edema and were assigned to NIV (i.e., continuous positive airway pressure [CPAP] or bilevel ventilation) or standard medical care (primarily loop diuretics, nitrate agents, and oxygen). Average follow-up was 2 w…

Reviewing Author

Daniel D. Dressler, MD, MSc, SFHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Daniel D. Dressler, MD, MSc, SFHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

For Heart Failure Exacerbation, It's Time to Vent (Noninvasively)

Topics

Reviewing Author