Is the Flow-Safe Disposable Continuous Positive Airway Pressure (CPAP) System as Effective as Non-Invasive Mechanical Ventilation (NIMV) in the Treatment of Acute Cardiogenic Pulmonary Oedema?
Project no. 115 · Status: Kapanmış · 2017
Summary
Background Acute cardiogenic pulmonary oedema (ACPO) is a common cause of severe respiratory failures that results in admissions to the emergency department. The aim of this study was to compare the flow-safe disposable continuous positive airway pressure (CPAP) system (FSD-CPAP-S) with non-invasive mechanical ventilation (NIMV), which is primarily preferred for non-invasive positive pressure ventilation (NPPV) in the treatment of diagnosed patients. Methods The study was designed as a single-centre, prospective and randomised control study. It included patients diagnosed with ACPO between 01 January and 31 December, 2018, who were treated with either NIMV or FSD-CPAP-S based on their randomisation. The patients’ blood pressure, pulse, respiratory rate and blood gas parameters as well as their Ege Acute Cardiogenic Pulmonary Oedema Severity Scoring system (Ege-ACPOSS) scores, which was designed for the study, were recorded at the time of admission and at the 30th and 60th min and compared between the groups. Results The mean age of the 181 patients included in the study was 71.5 ± 11.1 years, and 48.1% were male and 51.9% were female. When treatment effectiveness was compared between the groups, no statistically significant difference was found in systolic and diastolic blood pressures, heart rates, saturation values, bicarbonate levels, base excess, lactate levels and Ege-ACPOSS scores of the patients at the time of admission and at the 30th and 60th min after admission. Conclusion Considering the improvement observed in the physiological and blood gas parameters, patient severity scores, mortality and cost-related considerations of patients with ACPO, the FSD-CPAP-S can be as effective as NIMV and preferred in emergency services if there are insufficient NIMV devices. Keywords: non-invasive ventilation, flow-safe disposable CPAP system, acute cardiogenic pulmonary oedema, emergency medicine