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CHAPTER 8 NONINVASIVE VENTILATION IN PULMONARY EDEMA
Efficacy and Safety of Non-invasive Ventilation in the Treatment of Acute Cardiogenic Pulmonary Edema – A Systemic Review and Meta-analysis
Winck JC, Azevedo LF, Costa-Pereira A, et al. Crit Care. 2006;10(2):R69
BACKGROUND
Heart failure and acute pulmonary edema are frequent reasons for ED admission, and heart failure is the most common cause of hospital admission in patients over 65. These diseases are associated with high mortality and appropriate treatment can be resource intensive and expensive. Both continuous positive airway pressure ventilation (CPAP) and noninvasive positive pressure ventilation (NPPV or BiPAP) had become critical tools in the treatment of these patients; however, at the time of this meta-analysis several studies had left important unanswered questions: One showed that CPAP decreased the need for endotracheal intubation but had no effect on mortality while another suggested that NPPV may be associated with increased incidence of acute myocardial infarction (AMI).