Clinical effecitivity of non-invasive ventilation in patients with acute cardiogenic pulmonary edema

Cardiogenic pulmonary edema (CPE) is among the most common causes of acute respiratory failure. In patients with acute respiratory failure due to CPE, the use of non-invasive positive airway pressure can decrease the systemic venous return and the left ventricular afterload.

Our goal was to assess the clinical effectiveness of non-invasive ventilation (NIV) by comparing it with conventional oxygen therapy in patients with acute CPE.

The study involved 208 patients with acute CPE in total. The patients were divided into two groups. 105 patients with acute CPE were assigned to NIV (Group 1) and 103 patients were assigned to standard oxygen therapy (Group 2). The groups' other characteristics were similar. The primary endpoint for the comparison between NIV and standard oxygen therapy was in-hospital mortality. We selected the rate of endotracheal intubation and hospital stays as secondary endpoints.

In-hospital death was 1.9% (2 of 105 patients) in group 1 and 8.7% (9 of 103 patients) in group 2 (p =0.032). The rate of endotracheal intubation was 3.8% (4 of 105 patients) and 11.7% (12 of 103 patients) respectively(p=0.039). Hospital stays were, on average, 7.3 ± 2.5 days in group 1 and 8.7 ± 3.8 days in group 2 (p=0.0019).

In patients with acute CPE, NIV decreases the in-hospital mortality rate. Also, NIV can be an effective method for reducing hospital stays and the rate of endotracheal intubation in patients with acute CPE.