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Bi-level Versus Continuous Positive Airway Pressure in Acute Cardiogenic Pulmonary Edema: A Randomized Control Trial

Received: 12 December 2015     Accepted: 27 December 2015     Published: 8 January 2016
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Abstract

This study was to compare the efficacy of continuous, bi-level positive airway pressure (CPAP, Bi-PAP) and oxygen therapy on detailed observation of time-course change in blood gases, physiological parameters and rate of endotracheal intubation in patient with acute cardiogenic pulmonary edema (ACPE). Sixty-six patients with ACPE were randomly assigned to receive standard oxygen (O2) therapy (n=23), CPAP (n=21), and Bi-PAP (n=22). Blood gases (PaCO2, PaO2, SaO2, pH, and HCO3), and physiological parameters (HR, RR, SBP, and DBP) were collected at baseline (T0), immediately after 60 minutes (T60), and after 30 minutes of discontinuation (T90). A significant improvements (p<0.05) in PaCO2, PaO2, SaO2 and vital signs were observed immediately after CPAP and Bi-PAP when compared to O2 therapy. After 30 minutes of disconnection, Bi-PAP revealed significant improvement (p<0.05) in PaO2, SaO2, and respiratory rate. No differences on intubation and death rate detected among treatment groups. Both methods of noninvasive ventilations are effective treatment for ACPE. However, Bi-PAP should be considered as first line of treatment due to faster and continuous improvement in oxygenation and respiratory rate.

Published in Clinical Medicine Research (Volume 4, Issue 6)
DOI 10.11648/j.cmr.20150406.19
Page(s) 221-228
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2016. Published by Science Publishing Group

Keywords

Continuous Positive Airway Pressure, Bi-level Positive Airway Pressure, Acute Cardiogenic Pulmonary Edema

References
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Cite This Article
  • APA Style

    Basant Hamdy El-Refay, Rehab Farrag Gwada, Bassem S. Ibrahim. (2016). Bi-level Versus Continuous Positive Airway Pressure in Acute Cardiogenic Pulmonary Edema: A Randomized Control Trial. Clinical Medicine Research, 4(6), 221-228. https://doi.org/10.11648/j.cmr.20150406.19

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    ACS Style

    Basant Hamdy El-Refay; Rehab Farrag Gwada; Bassem S. Ibrahim. Bi-level Versus Continuous Positive Airway Pressure in Acute Cardiogenic Pulmonary Edema: A Randomized Control Trial. Clin. Med. Res. 2016, 4(6), 221-228. doi: 10.11648/j.cmr.20150406.19

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    AMA Style

    Basant Hamdy El-Refay, Rehab Farrag Gwada, Bassem S. Ibrahim. Bi-level Versus Continuous Positive Airway Pressure in Acute Cardiogenic Pulmonary Edema: A Randomized Control Trial. Clin Med Res. 2016;4(6):221-228. doi: 10.11648/j.cmr.20150406.19

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  • @article{10.11648/j.cmr.20150406.19,
      author = {Basant Hamdy El-Refay and Rehab Farrag Gwada and Bassem S. Ibrahim},
      title = {Bi-level Versus Continuous Positive Airway Pressure in Acute Cardiogenic Pulmonary Edema: A Randomized Control Trial},
      journal = {Clinical Medicine Research},
      volume = {4},
      number = {6},
      pages = {221-228},
      doi = {10.11648/j.cmr.20150406.19},
      url = {https://doi.org/10.11648/j.cmr.20150406.19},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20150406.19},
      abstract = {This study was to compare the efficacy of continuous, bi-level positive airway pressure (CPAP, Bi-PAP) and oxygen therapy on detailed observation of time-course change in blood gases, physiological parameters and rate of endotracheal intubation in patient with acute cardiogenic pulmonary edema (ACPE). Sixty-six patients with ACPE were randomly assigned to receive standard oxygen (O2) therapy (n=23), CPAP (n=21), and Bi-PAP (n=22). Blood gases (PaCO2, PaO2, SaO2, pH, and HCO3), and physiological parameters (HR, RR, SBP, and DBP) were collected at baseline (T0), immediately after 60 minutes (T60), and after 30 minutes of discontinuation (T90). A significant improvements (p2, PaO2, SaO2 and vital signs were observed immediately after CPAP and Bi-PAP when compared to O2 therapy. After 30 minutes of disconnection, Bi-PAP revealed significant improvement (p2, SaO2, and respiratory rate. No differences on intubation and death rate detected among treatment groups. Both methods of noninvasive ventilations are effective treatment for ACPE. However, Bi-PAP should be considered as first line of treatment due to faster and continuous improvement in oxygenation and respiratory rate.},
     year = {2016}
    }
    

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    AU  - Basant Hamdy El-Refay
    AU  - Rehab Farrag Gwada
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    AB  - This study was to compare the efficacy of continuous, bi-level positive airway pressure (CPAP, Bi-PAP) and oxygen therapy on detailed observation of time-course change in blood gases, physiological parameters and rate of endotracheal intubation in patient with acute cardiogenic pulmonary edema (ACPE). Sixty-six patients with ACPE were randomly assigned to receive standard oxygen (O2) therapy (n=23), CPAP (n=21), and Bi-PAP (n=22). Blood gases (PaCO2, PaO2, SaO2, pH, and HCO3), and physiological parameters (HR, RR, SBP, and DBP) were collected at baseline (T0), immediately after 60 minutes (T60), and after 30 minutes of discontinuation (T90). A significant improvements (p2, PaO2, SaO2 and vital signs were observed immediately after CPAP and Bi-PAP when compared to O2 therapy. After 30 minutes of disconnection, Bi-PAP revealed significant improvement (p2, SaO2, and respiratory rate. No differences on intubation and death rate detected among treatment groups. Both methods of noninvasive ventilations are effective treatment for ACPE. However, Bi-PAP should be considered as first line of treatment due to faster and continuous improvement in oxygenation and respiratory rate.
    VL  - 4
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Author Information
  • Department of Physical Therapy for Cardiovascular/Respiratory Disorders and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt

  • Department of Physical Therapy, National Heart Institute, Giza, Egypt

  • Heart Failure Unit, National Heart Institute, Giza, Egypt

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