title: Experience of step-wise protocol using noninvasive positive pressure ventilation for treating cardiogenic pulmonary edema.
abstract: Initiating and weaning procedure of noninvasive positive pressure ventilation (NIPPV) on acute cardiogenic pulmonary edema (ACPE) has been determined empirically, and the total time of its use has been sometimes prolonged unnecessarily. A simple protocol for its use may facilitate initiation and avoids prolongation of the NIPPV treatment. We designed a step-wise protocol for NIPPV use and retrospectively examined the clinical outcome of our protocol for initiation and weaning of NIPPV in 45 patients with ACPE. Almost all patients recovered from respiratory distress successfully. There was no intubation nor complication related to NIPPV. In most of the cases, maximal-end expiratory pressure was less than 7-cm H2O. The mean duration of NIPPV was 19.5±28.0 h and the median duration was 8.0 h (interquartile range=14.0 h). This simple step-wise NIPPV protocol for ACPE can facilitate quick and safe initiation and termination of the treatment.
authors.affiliation: The Cardiology Division, Saiseikai Futsukaichi Hospital, Fukuoka, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Momii
authors.forename: Yuki
authors.initials: Y
authors.lastname: Tashima
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kadokami
authors.forename: Sumito
authors.initials: S
authors.lastname: Narita
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Ando
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D008297:Male; D010101:Oxygen Consumption; D011175:Positive-Pressure Respiration / Q000295:instrumentation / Q000379:methods*; D011654:Pulmonary Edema / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies