Year : 2012  |  Volume : 1  |  Issue : 1  |  Page : 37-41

Noninvasive ventilation in patients with acute cardiogenic pulmonary oedema: A prospective study to quantify adequate PEEP

1 Assistant Professor of Respiratory Therapy, Manipal College of Allied Health Sciences, Manipal, India
2 Professor of Anaesthesiology, Kasturba Medical College, Manipal, India

Correspondence Address:
Meeti Sivadas
Assistant Professor of Respiratory Therapy, Manipal College of Allied Health Sciences, Manipal
Login to access the Email id

Source of Support: None, Conflict of Interest: None

Rights and PermissionsRights and Permissions

Introduction: Patients with heart failure developing acute pulmonary oedema benefit from immediate administration of noninvasive respiratory support such as continuous positive airway pressure (CPAP) or Biphasic positive airway pressure (BIPAP). Objective: To quantify the most advantageous positive end-expiratory pressure (PEEP) required to improve patient's oxygenation and to evaluate outcome of noninvasive respiratory support in patients with cardiogenic pulmonary oedema. Methods: This was a nonrandomised interventional study. Patients admitted with acute cardiogenic pulmonary oedema to the cardiac intensive care unit were initiated on CPAP/BIPAP mode of ventilation noninvasively. They were evaluated for the most advantageous PEEP that improved their symptoms. Results: A total of thirty two patients were studied. Twenty four patients were included in the CPAP group [mean (± SD) age of (63.66 ± 11.18) years)] and eight in BIPAP group [mean (± SD) age of (67.25 ± 12.6) years]. Most advantageous PEEP (mean (± SD) in CPAP group was 5.62 ± 1.24 cm H2O and in BIPAP group was 7.125 ± 1.8 cm H2O (P = 0.0125). Lower serum bicarbonate levels were found at baseline in the BIPAP group (14.4 ± 6.3 mmol/L) compared to CPAP group (19.4 ± 5.59 mmol/L, P < 0.041). Patients in BIPAP group needed a longer hospital stay (19.62 ± 14.9 days) compared to CPAP group of 8.12 ± 6.58 days (P 0.0047). Conclusions: Most patients of cardiogenic pulmonary oedema can be managed noninvasively with CPAP but patients with metabolic acidosis are likely to require BIPAP and a longer duration of hospital stay.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded76    
    Comments [Add]    

Recommend this journal