Non-invasive ventilation in cardiogenic pulmonary edema
Cardiogenic pulmonary edema (CPE) is one of the most common causes of acute respiratory failure (ARF) in acute care setting and often requires ventilatory assistance. In patients with CPE, either non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) have been demonstrated to improve vital signs and physiologic variables, decreasing the need for intubation and hospital mortality when compared to conventional treatment. In these patients, NIV and CPAP have consistently shown similar outcomes. Results on the use of NIV or CPAP in patients with CPE prior to hospitalization are not homogeneous among studies, thus preventing a firm recommendation regarding their role in pre-hospital setting. Over the past few years, technical innovations and new advances in the understanding of physiological aspects of NIV have improved the quality of the devices and optimized ventilation modes.