B Hoffmann1, T Welte. 1. Department of Cardiology, Angiology and Pneumology, Otto-von-Guericke University, Magdeburg, Germany.
Abstract
OBJECTIVE: Experimental use of noninvasive pressure support ventilation (NIPSV) in patients with severe pulmonary oedema who would have been intubated if noninvasive ventilation were not available. DESIGN: Open, prospective, within patients non comparative study. SETTING: Internal intensive care unit (11 beds) at a university hospital. PATIENTS: 29 patients with severe respiratory distress and confirmed pulmonary oedema. INTERVENTIONS: NIPSV was applied via a tight fitting face mask delivering between 13 and 24 cm H2O inspiratory airway pressure and 2 to 8 cm H2O expiratory airway pressure. MEASUREMENTS AND RESULTS: One patient required endotracheal intubation. Mean plethysmographic oxygen saturation rose significantly within 30 min from 73.8+/-11 to 90.3+/-5%, while the oxygen supply was reduced from 7.3+/-3.7 to 5.1+/-3 l/min. Mean pH increased significantly (p<0.01) from 7.22+/-0.1 before NIPSV to 7.31+/-0.07 after 60 min of NIPSV. Partial pressure of carbon dioxide was 62+/-18.5 mmHg but decreased significantly within 60 min to 48.4+/-11.5 mm Hg. Heart rate and-blood pressure stabilised continuously during the observation time. Mean duration of NIPSV was 6 h 9 min (range 60 min to 24 h). There were no serious side effects. Four patients died from underlying diseases between 1 and 28 days after NIPSV. CONCLUSION: NIPSV is a highly effective technique with which to treat patients with severe cardiogenic pulmonary oedema.
OBJECTIVE: Experimental use of noninvasive pressure support ventilation (NIPSV) in patients with severe pulmonary oedema who would have been intubated if noninvasive ventilation were not available. DESIGN: Open, prospective, within patients non comparative study. SETTING: Internal intensive care unit (11 beds) at a university hospital. PATIENTS: 29 patients with severe respiratory distress and confirmed pulmonary oedema. INTERVENTIONS:NIPSV was applied via a tight fitting face mask delivering between 13 and 24 cm H2O inspiratory airway pressure and 2 to 8 cm H2O expiratory airway pressure. MEASUREMENTS AND RESULTS: One patient required endotracheal intubation. Mean plethysmographic oxygen saturation rose significantly within 30 min from 73.8+/-11 to 90.3+/-5%, while the oxygen supply was reduced from 7.3+/-3.7 to 5.1+/-3 l/min. Mean pH increased significantly (p<0.01) from 7.22+/-0.1 before NIPSVto 7.31+/-0.07 after 60 min of NIPSV. Partial pressure of carbon dioxide was 62+/-18.5 mmHg but decreased significantly within 60 min to 48.4+/-11.5 mm Hg. Heart rate and-blood pressure stabilised continuously during the observation time. Mean duration of NIPSV was 6 h 9 min (range 60 min to 24 h). There were no serious side effects. Four patients died from underlying diseases between 1 and 28 days after NIPSV. CONCLUSION:NIPSV is a highly effective technique with which to treat patients with severe cardiogenic pulmonary oedema.
Authors: Sean P Keenan; Tasnim Sinuff; Karen E A Burns; John Muscedere; Jim Kutsogiannis; Sangeeta Mehta; Deborah J Cook; Najib Ayas; Neill K J Adhikari; Lori Hand; Damon C Scales; Rose Pagnotta; Lynda Lazosky; Graeme Rocker; Sandra Dial; Kevin Laupland; Kevin Sanders; Peter Dodek Journal: CMAJ Date: 2011-02-14 Impact factor: 8.262
Authors: Andrea Bellone; Marco Vettorello; Alessandra Monari; Francesca Cortellaro; Daniele Coen Journal: Intensive Care Med Date: 2005-05-04 Impact factor: 17.440