[Non-invasive positive pressure ventilation in cardiogenic pulmonary edema].

METHODS

30 patients being admitted to our intensive care unit with severe cardiogenic pulmonary edema received non-invasive positive pressure ventilation (NIPPV) via face mask.

RESULTS

29 responded well, 1 patient had to be intubated. Within 30 minutes those who responded well showed a significant improvement of the following parameters: rise of peripheral saturation from 75.5 to 90.1% and of pH from 7.24 to 7.29, decrease of pCO2 from 60.7 to 48.8 mm Hg and of systolic blood pressure from 144 to 124 mm Hg. Mean duration of ventilation was 6 h 55 min. Mean stay in intensive care unit was 2 days. No patient required ventilator support within 24 hours after NIPPV. Four patients died during hospital stay as a result of their underlying disease but not due to pulmonary edema. Observed side effects were vomiting in 4 cases during NIPPV without aspiration and 3 cases of skin lesions which healed uneventfully.

CONCLUSIONS

Key role for this highly effective method seems to be the rapid improvement of left ventricular function during NIPPV.