Continuous and bilevel positive airway pressure in the treatment of acute cardiogenic pulmonary edema.
Patients with acute cardiogenic pulmonary edema (ACPE) are commonly seen in the emergency department (ED). Although the majority of patients respond to conventional medical therapy, some patients require at least temporary ventilatory support. Traditionally, this has been accomplished via endotracheal intubation and mechanical ventilation, an approach that is associated with a small but significant rate of complications. The past 2 decades have witnessed increasing interest in methods of noninvasive ventilatory support (NVS), notably continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP). We review the physiological consequences, clinical efficacy, and practical limitations of CPAP and BiPAP in the management of ACPE.
Kosowsky
J M
JM
Department of Emergency Medicine and Center for Emergency Care, University of Cincinnati College of Medicine, OH 45267-0769, USA.
Storrow
A B
AB
Carleton
S C
SC
D000208:Acute Disease; D004638:Emergency Treatment / Q000379:methods*; D006331:Heart Diseases / Q000150:complications*; D006439:Hemodynamics; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008991:Monitoring, Physiologic; D018579:Patient Selection; D011175:Positive-Pressure Respiration / Q000295:instrumentation / Q000379:methods*; D011652:Pulmonary Circulation; D011654:Pulmonary Edema / Q000097:blood / Q000209:etiology* / Q000628:therapy*; D012121:Respiration, Artificial / Q000009:adverse effects; D016896:Treatment Outcome