Clinical Experience of Noninvasive Positive Pressure Ventilation in Patients with Acute Cardiogenic Pulmonary Oedema Treated in a Community Hospital in JapanEisaku Okuyama1*, Masami Yano1, Seigo Sugiyama2, Takashi Miyazaki1, Tetsuji Katayama1, Keisuke Watanabe1, Koichi Kikuta1, Daisuke Sato1, Keijiro Abe1,Kunihiko Matsui3, Hisao Ogawa2 and Natsuki Nakamura1
- *Corresponding Author:
- Eisaku Okuyama, MD, PhD
Divisions of Emergency Medicine and Intensive Care
Shinbeppu Hospital, 3898 Oaza Tsurumi
Beppu, Oita 874-0833, Japan
E-mail: [email protected]
Received Date: May 30, 2014; Accepted Date: July 03, 2014; Published Date: July 15, 2014
Citation: Okuyama E, Yano M, Sugiyama S, Miyazaki T, Katayama T, et al. (2014) Clinical Experience of Noninvasive Positive Pressure Ventilation in Patients with Acute Cardiogenic Pulmonary Oedema Treated in a Community Hospital in Japan. Emerg Med (Los Angel) 4:196. doi:10.4172/2165-7548.1000196
Copyright: © 2014 Okuyama E . This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: To review our use of non-invasive positive pressure ventilation (NPPV) for acute cardiogenic pulmonary oedema (ACPO) in the routine clinical management, especially in terms of the timing of endotracheal intubation (ETI) and outcome. Methods: We retrospectively reviewed 61 patients diagnosed with ACPO admitted to our emergency room (ER) or intensive care unit (ICU) and who received NPPV. The reasons for ETI were reviewed, and the intervals between the estimated appropriate time for ETI and the actual time of ETI and in-hospital mortality were recorded. Results: The mortality rate of patients receiving NPPV was 8.2% (five out of 61). Forty-eight patients (78.7%) were successfully weaned off NPPV without ETI, and 13 (21.3%) required ETI. Five of the 13 intubated patients died, but there was no significant difference in the duration of NPPV before ETI between those who survived and those who died. The interval between the estimated appropriate time for ETI and the actual time of ETI was significantly shorter in patients who survived than in those who died (1.9 ± 3.8 hours versus 8.6 ± 5.4 hours, p=0.02). The mortality rate was significantly higher in patients with an interval of longer than 1.8 hours between the estimated appropriate time for ETI and the actual time of ETI (66.7% versus 14.3%, p<0.001). Conclusions: In patients with ACPO receiving NPPV, a delay in performing ETI beyond the appropriate time was significantly associated with increased mortality. The duration of NPPV before ETI was not associated with mortality.