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Báo cáo y học: "The role of noninvasive ventilation in acute cardiogenic pulmonary edema"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: The role of noninvasive ventilation in acute cardiogenic pulmonary edema. | Salman et al. Critical Care 2010 14 303 http ccforum.eom content 14 2 303 CRITICAL CARE JOURNAL CLUB CRITIQUE L The role of noninvasive ventilation in acute cardiogenic pulmonary edema Ashar Salman 1 Eric B Milbrandt2 and Michael R Pinsky3 University of Pittsburgh Department of Critical Care Medicine Evidence-Based Medicine Journal Club edited by Eric B Milbrandt z------------------------------------------------------------------------------------------------------- Expanded Abstract Citation Gray A Goodacre S Newby DE Masson M Sampson F Nicholl J Noninvasive ventilation in acute cardiogenic pulmonary edema. N Engl J Med 2008 359 142-151 1 . Background Noninvasive ventilation NIV continuous positive airway pressure CPAP or noninvasive intermittent positivepressure ventilation NIPPV appears to be of benefit in the immediate treatment of patients with acute cardiogenic pulmonary edema and may reduce mortality. Methods Objective To determine whether noninvasive ventilation reduces mortality and whether there are important differences in outcome associated with the method of treatment CPAP or NIPPV . Design Open prospective randomized controlled trial. Setting 26 emergency departments in hospital in the UK between July 2003 and April 2007. Subjects 1069 patients age 16 years with a clinical diagnosis of acute cardiogenic pulmonary edema as determined by chest radiograph respiratory rate 20 breaths min and arterial pH 7.35. Exclusion criteria included a requirement for a lifesaving or emergency intervention inability to give consent or previous recruitment in the trial. Intervention All patients received standard concomitant therapy. Patients were randomly assigned to standard oxygen therapy up to 15 liters per minute via face mask CPAP 5 to 15 cm of water or NIPPV inspiratory pressure 8 to 20 cm of water expiratory pressure 4 to 10 cm of water . Outcomes The primary end point for the comparison between noninvasive ventilation and standard oxygen