Non-Invasive Mechanical Ventilation Compared to Positive Airway Pressure in Cardiogenic Pulmonary Edema

2018 ◽  
Vol 54 (11) ◽  
pp. 594
Author(s):  
José Manuel Carratalá ◽  
Víctor Gil ◽  
Javier Jacob ◽  
Pere Llorens
Keyword(s):  
Mechanical Ventilation ◽  
Pulmonary Edema ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Invasive Mechanical Ventilation ◽  
Cardiogenic Pulmonary Edema ◽  
Non Invasive

scholarly journals Penggunaan Ventilasi Mekanik non Invansif Untuk Mengatasi Kegagalan Pernafasan pada Pasien dengan Edema Pulmo Akut Kardiogenik

2020 ◽  
Vol 1 (2) ◽  
pp. 91-100
Author(s):  
Eva Marti
Keyword(s):  
Mechanical Ventilation ◽  
Pulmonary Edema ◽  
Airway Pressure ◽  
Oxygen Therapy ◽  
Positive Airway Pressure ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Mechanical Ventilation ◽  
Non Invasive ◽  
Bilevel Positive Airway Pressure ◽  
First Choice

Background: Cardiogenic Pulmo edema can cause a heterogeneous syndrome with a mortality rate of up to 9.5% (Aliberti et all., 2018).Objective: The purpose of this paper was to explain how effective the use of non-invasive mechanical ventilation in patients with acute pulmonary edema with respiratory failure. Methods: The literature review was compiled by synthesizing and comparing various relevant scientific articles from the literature search results using the online database of Proquest and Clinicalkey Elsevier that have significance related to the management of acute cardiogenic pulmo edema. Result: Compared with conservative therapy,  noninvasive mechanical ventilation has been shown more effective in improving oxygenation in patients with acute cardiogenic pulmo edema Non-invasive ventilation can reduce dyspnea, acidosis and hypercapnea faster than standard oxygen therapy. Studies show that compared to endotracheal intubation, non-invasive mechanical ventilation is associated with a lower risk of nosocomial infection, lower antibiotic use, shorter length of stay in intensive care units and lower mortality. Study found that there were no differences betwen the two setting of non-invasive mechanical ventilation used, Bilevel positive Airway Pressure (BiPAP) and Continues positive Airway Pressure (CPAP) in  patients outcomes. However, there are absolute and relative contraindications that must be considered, including the effectiveness of the therapy being insignificant when given too late Conclusion: Noninvasive mechanical ventilation can be considered as the first choice in the management of acute cardiogenic pulmonary edema because of its high clinical effectiveness representing a rescue action for patients not improving with conventional oxygen therapy.

scholarly journals Non-invasive duo positive airway pressure ventilation versus nasal continuous positive airway pressure in preterm infants with respiratory distress syndrome: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arash Malakian ◽  
Mohammad Reza Aramesh ◽  
Mina Agahin ◽  
Masoud Dehdashtian
Keyword(s):  
Mechanical Ventilation ◽  
Continuous Positive Airway Pressure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Abstract Background The most common cause of respiratory failure in premature infants is respiratory distress syndrome. Historically, respiratory distress syndrome has been treated by intratracheal surfactant injection followed by mechanical ventilation. In view of the risk of pulmonary injury associated with mechanical ventilation and subsequent chronic pulmonary lung disease, less invasive treatment modalities have been suggested to reduce pulmonary complications. Methods 148 neonates (with gestational age of 28 to 34 weeks) with respiratory distress syndrome admitted to Imam Khomeini Hospital in Ahwaz in 2018 were enrolled in this clinical trial study. 74 neonates were assigned to duo positive airway pressure (NDUOPAP) group and 74 neonates to nasal continuous positive airway pressure (NCPAP) group. The primary outcome in this study was failure of N-DUOPAP and NCPAP treatments within the first 72 h after birth and secondary outcomes included treatment complications. Results there was not significant difference between DUOPAP (4.1 %) and NCPAP (8.1 %) in treatment failure at the first 72 h of birth (p = 0.494), but non-invasive ventilation time was less in the DUOPAP group (p = 0.004). There were not significant differences in the frequency of patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia (BPD), apnea and mortality between the two groups. Need for repeated doses of surfactant (p = 0.042) in the NDUOPAP group was significantly lower than that of the NCPAP group. The duration of oxygen therapy in the NDUOPAP group was significantly lower than that of the NCPAP group (p = 0.034). Also, the duration of hospitalization in the NDUOPAP group was shorter than that of the NCPAP group (p = 0.002). Conclusions In the present study, DUOPAP compared to NCPAP did not reduce the need for mechanical ventilation during the first 72 h of birth, but the duration of non-invasive ventilation and oxygen demand, the need for multiple doses of surfactant and length of stay in the DUOPAP group were less than those in the CPAP group. Trial registration IRCT20180821040847N1, Approved on 2018-09-10.

scholarly journals The role of Continuous Positive Airway Pressure (CPAP) in Delaying or Avoiding Mechanical Ventilation in COVID-19 Respiratory Failure: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Allan Cameron ◽  
Sharif Fattah ◽  
Laura Knox ◽  
Pauline Grose
Keyword(s):  
Mechanical Ventilation ◽  
Cohort Study ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Support ◽  
Royal Infirmary ◽  
High Dependency ◽  
Number Of Patients

Abstract Background - During the winter of 2020-2021, the second wave of the COVID19 pandemic in the United Kingdom caused increased demand for intensive care unit (ICU) beds, and in particular, for invasive mechanical ventilation (IMV). To alleviate some of this pressure, some centres offered non-invasive continuous positive airway pressure (CPAP), delivered on specialised COVID high dependency units (cHDUs). However, this practice was based largely on anecdotal reports, and it is not clear from the literature how effective CPAP is at delaying or preventing IMV. Methods - This was a retrospective observational cohort study of consecutive patients admitted to a specialised cHDU at Glasgow Royal Infirmary between November 2020 and February 2021. Each patient had a continuous record of the level of respiratory support required, and was followed up to hospital discharge or death. We examined patient outcomes according to age, sex and maximum level of respiratory support, using logistic regression and time-to-event analysis. The number of patients who could not be oxygenated by standard oxygen facemask but could be oxygenated by CPAP was counted and compared to the number of patients admitted to ICU for IMV over the same period.Results - There were 152 admissions to cHDU over the study period. Of these, 125 received CPAP treatment. Of the patients who received support in cHDU, the overall mortality rate was 37.9% (95% CI 30.3% - 46.1%)). Odds of mortality were closely correlated with increasing age and oxygen requirement. Of the 152 patients, 44 patients (28.8%, 95% CI 22.0 – 36.9%) went on to require IMV in ICU. This represents 77.2% of the 57 COVID-19 admissions to ICU during the same period. However, there were also 41 patients who received levels of respiratory support on cHDU which would normally necessitate ICU admission but who never went to ICU, potentially reducing ICU admissions by 41.8% (95% CI 32.1 – 52.2%).Conclusion - Providing respiratory support in cHDU reduced the number of potential ICU admissions by 41.8%, as well as delaying IMV for over 75% of ICU admissions. This represents a significant sparing of ICU capacity at a time when IMV beds were in high demand.

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