Ventilação não-invasiva no edema agudo do pulmão no Serviço de Urgência

Translated title of the contribution: Non-invasive ventilation in cardiogenic pulmonary edema in the Emergency Department

Luísa Carvalho, Rui Carneiro, Elga Freire, Paulo Pinheiro, Irene Aragão, Alfredo Martins

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Bilevel positive pressure (BiPAP) non-invasive ventilation (NIV) is frequently used in our Emergency Department (ED), as an adjuvant in the treatment of acute cardiogenic pulmonary edema (ACPE) to reduce the need for tracheal intubation (TI) in these patients. The purpose of our study was to evaluate the safety of NIV in patients with ACPE in our ED, used by a group of physicians outside the intensive care unit (ICU), by comparing our results with previously published results. We also wanted to identify possible additional advantages of NIV in the treatment of ACPE. We recorded clinical and physiological data before and after NIV of all patients with diagnosis and treatment of ACPE in our ED and for whom NIV was ordered as adjuvant treatment, between July 2004 and February 28 2005. During this period, NIV was ordered in 17 patients with ACPE. The mean ventilation pressures used were Pinsp 16.5±5 cm H2O and Pexp 8.8±4 cm H 2O. None of the patients refused NIV In six patients NIV was not initiated immediately together with medical therapeutics. One patient required TI and the other 16 (94%) improved after NIV. After the ACPE episode had resolved, fourteen patients (82%) were eventually discharged from hospital whereas 3 (18%) died during hospitalization. We observed a statistically significant improvement after one hour of NIV in respiratory and pulse rate, arterial pH, PaCO2 and peripheral blood O2 saturation. Despite the small sample size, these results suggest that it is possible to use NIV in the treatment of ACPE outside the ICU, without increasing the risks of TI or decreasing efficacy. In these cases NIV probably accelerates clinical resolution and relieves symptoms.

Translated title of the contributionNon-invasive ventilation in cardiogenic pulmonary edema in the Emergency Department
Original languagePortuguese
Pages (from-to)191-198
Number of pages8
JournalRevista Portuguesa de Cardiologia
Volume27
Issue number2
StatePublished - Feb 1 2008
Externally publishedYes

Keywords

  • Acute cardiogenic pulmonary edema
  • Acute respiratory failure
  • Emergency Department
  • Non-invasive pressure support ventilation
  • Non-invasive ventilation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Carvalho, L., Carneiro, R., Freire, E., Pinheiro, P., Aragão, I., & Martins, A. (2008). Ventilação não-invasiva no edema agudo do pulmão no Serviço de Urgência. Revista Portuguesa de Cardiologia, 27(2), 191-198.