Noninvasive Pressure Control Inverse Ratio Ventilation (NIPCIRV) Versus Conventional Oxygen Therapy for Treatment of Acute Cardiogenic Pulmonary Edema

摘要

Previous studies suggesting the use of non-invasive ventilation modes in patients with Acute Cardiogenic Pulmonary Edema (ACPE). However, there are controversies regarding the benefit of using non-invasive ventilation in patients with ACPE. This study investigated the short-term effects of non Invasive Pressure Control Inverse Ratio Ventilation (NIPCIRV) on respiratory, homodynamic and oxygenation parameters in patients with acute respiratory failure due to Acute Cardiogenic Pulmonary Edema (ACPE). Moreover, intubation need and the duration of Cardiac Care Unit (CCU) stay in those patients were investigated.In this randomized clinical trial study, 120 patients were assigned conventional oxygen therapy or NIPCIRV by a standard ventilator through a face mask in addition to standardized pharmacological treatment. Physiological parameters were obtained at different time points (0, 15, 30 and 60 min) post NIPCIRV. The main end points were intubation, recorded recovery time (defined as oxygen saturation of 96% or more),respiratory rate <30 breaths/min) and duration of CCU stay.Endotracheal intubation was required in 2 (3.3%) of 60 assigned non NIPCIRV and in 12 (20%) of 60 assigned conventional therapy (p = 0.001). Recovery time was significantly shorter in the NIPCIRV group (48±8 h) compared with control group (96±12 h) (p<0.05). NIPCIRV led to a rapid improvement in oxygenation, respiratory rate, arterial PH, heart rate and blood pressure in the first hour (p = 0.0001 ) .There were significant differences in length of stay in coronary care unit, stay from (3±1 days) in NIPCIRV group vs (7±1) in control group (p = 0.0001). Hospital mortality was 17 patients (28.33%) in conventional group and 8 patients (13.33%) in NIPCIRV group (p<0.001). This study confirms that the non-invasive ventilation method of NIPCIRV is superior to conventional oxygen therapy.