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Intensive Care Med. 1999 Jan;25(1):15-20.

The use of noninvasive pressure support ventilation for severe respiratory insufficiency due to pulmonary oedema.

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  • 1Department of Cardiology, Angiology and Pneumology, Otto-von-Guericke University, Magdeburg, Germany.

Abstract

OBJECTIVE:

Experimental use of noninvasive pressure support ventilation (NIPSV) in patients with severe pulmonary oedema who would have been intubated if noninvasive ventilation were not available.

DESIGN:

Open, prospective, within patients non comparative study.

SETTING:

Internal intensive care unit (11 beds) at a university hospital. Patients: 29 patients with severe respiratory distress and confirmed pulmonary oedema.

INTERVENTIONS:

NIPSV was applied via a tight fitting face mask delivering between 13 and 24 cm H2O inspiratory airway pressure and 2 to 8 cm H2O expiratory airway pressure.

MEASUREMENTS AND RESULTS:

One patient required endotracheal intubation. Mean plethysmographic oxygen saturation rose significantly within 30 min from 73.8+/-11 to 90.3+/-5%, while the oxygen supply was reduced from 7.3+/-3.7 to 5.1+/-3 l/min. Mean pH increased significantly (p<0.01) from 7.22+/-0.1 before NIPSV to 7.31+/-0.07 after 60 min of NIPSV. Partial pressure of carbon dioxide was 62+/-18.5 mmHg but decreased significantly within 60 min to 48.4+/-11.5 mm Hg. Heart rate and-blood pressure stabilised continuously during the observation time. Mean duration of NIPSV was 6 h 9 min (range 60 min to 24 h). There were no serious side effects. Four patients died from underlying diseases between 1 and 28 days after NIPSV.

CONCLUSION:

NIPSV is a highly effective technique with which to treat patients with severe cardiogenic pulmonary oedema.

Comment in

PMID:
10051073
[PubMed - indexed for MEDLINE]
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