title: Noninvasive ventilation in pulmonary edema complicating acute myocardial infarction.
abstract: BACKGROUND
  Because it remains unclear whether noninvasive ventilation (NIV) is an effective therapy for cardiogenic pulmonary edema secondary to acute myocardial infarction (AMI), we retrospectively evaluated our experience with NIV in the treatment of pulmonary edema secondary to AMI and other cardiac conditions.
  
  
  RESULTS
  The study group included 206 patients with cardiogenic pulmonary edema, divided into an AMI group (53 patients) and a non-AMI group (153 patients). The weaning rate from NIV was similar in the AMI and non-AMI groups (90.6% vs. 90.8%, P=0.950). Heart rate, blood pressure, and respiratory rate decreased significantly 1h after initiation of NIV in both groups, and were maintained until weaning from NIV. The frequency of endotracheal intubation after weaning from NIV was higher in the AMI group than in the non-AMI group (7.5% vs. 0.7%, P=0.016), although the overall frequency of intubation was similar in both groups. The in-hospital mortality rate was similar in the AMI and non-AMI groups (13.1% vs. 9.8%, P=0.489).
  
  
  CONCLUSIONS
  NIV effectively improved vital signs and oxygenation and lowered the intubation rate in patients with cardiogenic pulmonary edema of all etiologies, including AMI. The outcome in patients with AMI treated with NIV depends primarily on the severity of the course of AMI and not on the severity of acute respiratory failure.
authors: Division of Intensive and Cardiac Care Unit, Nippon Medical School Hospital, Tokyo, Japan.
authors: Takeshi
authors: T
authors: Yamamoto
authors: Shinhiro
authors: S
authors: Takeda
authors: Naoki
authors: N
authors: Sato
authors: Koichi
authors: K
authors: Akutsu
authors: Hiroshi
authors: H
authors: Mase
authors: Keiko
authors: K
authors: Nakazato
authors: Kyoichi
authors: K
authors: Mizuno
authors: Keiji
authors: K
authors: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D005260:Female; D006339:Heart Rate; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D063087:Noninvasive Ventilation; D011654:Pulmonary Edema / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D056152:Respiratory Rate; D012189:Retrospective Studies