Chest
Clinical Investigations in Critical CareReappraisal of Continuous Positive Airway Pressure Therapy in Acute Cardiogenic Pulmonary Edema: Short-term Results and Long-term Follow-up
Section snippets
Patient Selection
From January 1, 1986, to December 31, 1992, all patients who presented with acute cardiogenic pulmonary edema, admitted to the coronary care unit of the Veterans General Hospital-Kaohsiung and Taipei, were considered potential candidates for participation in this prospective study. All patients underwent Swan-Ganz catheterization. To ensure relatively uniform medical treatment at study entry, a consensus was achieved on management guidelines for cardiogenic pulmonary edema: (1) if systolic
Results
During the period from January 1, 1986, to December 31, 1992, 100 patients who suffered from acute cardiogenic pulmonary edema were randomly assigned either to receive oxygen alone (control, n=50) or to receive oxygen plus serial, incremental CPAP therapy (n=50). Among them, 85 patients were recruited from the Emergency Department and 15 patients were recruited during hospitalization. No significant differences were found between these two groups at study entry (Table 1). Upon initial
Discussion
This study confirms that CPAP delivered through a face mask has several advantages over supplemental oxygen alone in the management of acute cardiogenic pulmonary edema.1, 2, 3, 4, 5 CPAP resulted in significant improvement in respiratory rate and intrapulmonary shunt and oxygenation, and fewer patients who received CPAP therapy required tracheal intubation.1, 2, 3 Although the avoidance of tracheal intubation and ventilator therapy by CPAP technique has been described previously,1, 2, 3 this
References (17)
- et al.
Continuous positive airway pressure by face mask in acute cardiogenic pulmonary edema
Am J Cardiol
(1985) - et al.
Mechanical work on the lungs and work of breathing with positive end-expiratory pressure and continuous positive airway pressure
Chest
(1979) - et al.
Alternations of hemodynamics and myocardial mechanics in patients with congestive heart failure: pathophysiologic mechanism and assessment of cardiac function and ventricular contractility
Prog Cardiovasc Dis
(1970) - et al.
Cardiac augmentation by phasic high intrathoracic pressure support in man
Chest
(1983) - et al.
PEEP and pulmonary edema
Am J Med
(1982) - et al.
Treatment of severe cardiogenic pulmonary edema with continuous positive airway pressure delivered by face mask
N Engl J Med
(1991) - et al.
Effectiveness of CPAP by mask for pulmonary edema associated with hypercarbia
Intensive Care Med
(1983) - et al.
Inspiratory work with and without continuous positive airway pressure in patients with acute respiratory failure
Anesthesiology
(1985)