Noninvasive ventilation in acute heart failure: use of continuous positive airway pressure in the emergency department

作者：Manuel Carratala Jose; Masip Josep

来源：Emergencias, 2010, 22(1): 49-55.

• Acute heart failure
• Noninvasive ventilation
• Emergency health services

Noninvasive ventilation is one of the ventilatory support systems available for treating the patient with acute respiratory failure. Orotracheal intubation is not required. The main modalities are continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP). Both alleviate respiratory distress quickly and have proven useful for treating acute heart failure due to acute pulmonary edema or pulmonary hypertension. The need for intubation and mortality are reduced. More experience has accumulated with CPAP, which is easier to manage and is associated with few complications. BiPAP, which is more complicated and requires more staff training, has been shown to improve respiratory failure more quickly in patients with heart failure and to be more effective in patients with hypercapnia or respiratory muscle fatigue. In spite of these benefits, noninvasive ventilation is little used in hospital emergency departments, probably because of the lack of staff training and commitment, low availability of material resources, and the absence of clear protocols, which ought to be available in all hospitals. This review aims to describe the role that noninvasive ventilation plays in improving oxygen saturation in the treatment of acute heart failure due to acute pulmonary edema or pulmonary hypertension and to define an appropriate protocol for using these modalities. [Emergencias 2010;22:49-55]

• 出版日期2010-2