بررسي مقايسه اي تاثير تهويه غير تهاجمي با روش فشار مثبت دو سطحي راه هوايي در درمان ادم حاد ريوي - قلبي

Evaluating the effects of Bilevel positive airway pressure versus conventional oxygen therapy for treatment acute cardiogenic pulmonary edema

Background: Recent studies suggest the use of non - invasive ventilation in patients with acute cardiogenic pulmonary edema (ACPE). However, it remains unclear whether patients with ACPE benefit from non - invasive ventilation. This study designed to investigate short - term effects of non - invasive ventilation on respiratory, hemodynamic and oxygenation parameters in patients with respiratory failure due to ACPE and to identify need for intubation, recovery and admission. Materials and methods: In this randomized clinical trial study, 80 patients assigned to conventional oxygen therapy or non - invasive ventilation supplied by a standard ventilator through a face mask with mode of bi-level positive airway pressure (BIPAP), in addition to standardized pharmacological treatment .Physiological parameters were obtained in 0, 15, 30, 60 minutes after non - invasive ventilation . The main end points were intubation and recorded recovery time (defined as oxygen saturation of 96% or more and respiratory rate less than 30 breaths / min )and ICU stay. c. f » jjyjtr-if j** Results: Endotracheal intubation was required in one (2.5%) of 40 assigned non - invasive ventilation and in six (15%) of 40 assigned conventional therapy (p= 0.1) recovery time was significantly shorter in the non - invasive ventilation group mean 42 ± 9.9 vs 131+22.5 (p= 0,0001) non - invasive ventilation led to a rapid improvement in oxygenation, respiratory rate, arterial PH, heart rate and blood pressure in the first hour (p= 0.0001). There were significant differences in intensive care unit length of stay 2.8+1.2 days in non - invasive ventilation group vs. 4.8 ± 1.5 in control group. (p= 0.0001). No hospitd mortality was recorded. Conclusions: In this study of acute cardiogenic pulmonary edema non - invasive ventilation in mode of BIPAP was superior to conventional oxygen therapy. We suggest further studies to compare bi-level positive airway pressure with continuous positive airway pressure non invasive ventilation on treatment in these patients.