Evolution of patients with cardiogenic pulmonary edema treated with non-invasive ventilation in the emergency department
Abstract
Introduction: Acute pulmonary edema is frequently treated in emergency departments and non-invasive ventilation is a new modality of ventilatory support used in its treatment.
Objective: To describe the variations in clinical, ventilatory and hemogasometric parameters in patients with cardiogenic pulmonary edema treated with non-invasive ventilation.
Method: A descriptive and cross-sectional study was carried out on 54 patients with acute pulmonary edema admitted to the Emergency Intensive Care Unit of the Hospital Provincial Saturnino Lora, in the city of Santiago de Cuba, from January 2019 to January 2020.
Results: Males (70.4% of patients) prevailed and mean age was 62 years old. The applied technique was successful in 90.7% of patients. After one hour of treatment there was an improvement in all clinical and hemogasometric parameters, except in sodium bicarbonate. Higher PEEP (positive end-expiratory pressure) values were required in patients where the technique failed and the frequency of the technique application was higher in patients where it was successful.
Conclusions: Patients with acute pulmonary edema, treated with non-invasive ventilation, evolved favorably with improvement in clinical, ventilatory and hemogasometric parameters.
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1. Masip J, Peacock WF, Price S, Cullen L, Martin-Sanchez FJ, Seferovic P, et al. Indications and practical approach to non-invasive ventilation in acute heart failure. Eur Heart J. 2018;39(1):17-25. DOI: https://doi.org/10.1093/eurheartj/ehx580
2. Esquinas AM, Benhamou MO, Glossop AJ, Mina B. Noninvasive mechanical ventilation in acute ventilatory failure: Rationale and Current Applications. Sleep Med Clin. 2017;12(4):597-606. DOI: https://doi.org/10.1016/j.jsmc.2017.07.009
3. Marino PL. Acute Heart Failure in the ICU. En: Marino’s, The ICU Book. 4ª Ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014. p. 239-62.
4. Barach AL, Martin J, Eckman M. Positive pressure respiration and its application to the treatment of acute pulmonary edema. Ann Int Med. 1938;12(6):754-95. DOI: https://doi.org/10.7326/0003-4819-12-6-754
5. Rochwerg B, Brochard L, Elliott MW, Hess D, Hill NS, Nava S, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J [Internet]. 2017 [citado 14 Ene 2020];50(2):1602426. Disponible en: https://doi.org/10.1183/13993003.02426-2016
6. Liesching T, Nelson DL, Cormier KL, Sucov A, Short K, Warburton R, et al. Randomized trial of bilevel versus continuous positive airway pressure for acute pulmonary edema. J Emerg Med. 2014;46(1):130-40. DOI: https://doi.org/10.1016/j.jemermed.2013.08.015
7. Gray A, Goodacre S, Newby DE, Masson M, Sampson F, Nicholl J, et al. Noninvasive ventilation in acute cardiogenic pulmonary edema. N Engl J Med. 2008;359(2):142-51. DOI: https://doi.org/10.1056/nejmoa0707992
8. Peter JV, Moran JL, Phillips-Hughes J, Graham P, Bersten AD. Effect of non-invasive positive pressure ventilation (NIPPV) on mortality in patients with acute cardiogenic pulmonary oedema: a meta-analysis. Lancet. 2006;367(9517):1155-63. DOI: https://doi.org/10.1016/s0140-6736(06)68506-1
9. Masip J, Roque M, Sánchez B, Fernández R, Subirana M, Expósito JA. Noninvasive ventilation in acute cardiogenic pulmonary edema: systematic review and meta-analysis. JAMA. 2005;294(24):3124-30. DOI: https://doi.org/10.1001/jama.294.24.3124
10. Weng CL, Zhao YT, Liu QH, Fu CJ, Sun F, Ma YL, et al. 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
11. Masip J, Betbesé AJ, Páez J, Vecilla F, Cañizares R, Padró J, et al. Non-invasive pressure support ventilation versus conventional oxygen therapy in acute cardiogenic pulmonary oedema: a randomised trial. Lancet. 2000;356(9248):2126-32. DOI: https://doi.org/10.1016/s0140-6736(00)03492-9
12. Park M, Sangean MC, Volpe M de S, Feltrim MI, Nozawa E, Leite PF, et al. Randomized, prospective trial of oxygen, continuous positive airway pressure, and bilevel positive airway pressure by face mask in acute cardiogenic pulmonary edema. Crit Care Med. 2004;32(12):2407-15. DOI: https://doi.org/10.1097/01.ccm.0000147770.20400.10
13. Winck JC, Azevedo LF, Costa-Pereira A, Antonelli M, Wyatt JC. Efficacy and safety of non-invasive ventilation in the treatment of acute cardiogenic pulmonary edema – A systematic review and meta-analysis. Crit Care [Internet]. 2006 [citado 20 Ene 2020];10(2):R69. Disponible en: https://doi.org/10.1186/cc4905
14. Collins SP, Mielniczuk LM, Whittingham HA, Boseley ME, Schramm DR, Storrow AB. The use of noninvasive ventilation in emergency department patients with acute cardiogenic pulmonary edema: A systematic review. Ann Emerg Med. 2006;48(3):260-9. DOI: https://doi.org/10.1016/j.annemergmed.2006.01.038
15. Mehta S, Al-Hashim AH, Keenan SP. Noninvasive ventilation in patients with acute cardiogenic pulmonary edema. Respir Care. 2009;54(2):186-95.
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