Randomized, prospective trial of bilevel versus continuous positive airway pressure in acute pulmonary edema
Randomized, prospective trial of bilevel versus continuous positive airway pressure in acute pulmonary edema
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DOI：
10.1097/00003246-199704000-00011
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发表时间：
1997-04-01
影响因子：
8.8
通讯作者：
Hill, NS
中科院分区：
文献类型：
--
作者：
Mehta, S;Jay, GD;Hill, NS
目的：评估双水平气道正压通气通过主动辅助吸入是否比持续气道正压通气 (CPAP) 更迅速地改善急性肺水肿患者的通气、酸血症和呼吸困难。设计：随机、对照、双盲试验。地点：一所大学医院急诊科。患者：27 名患有急性肺水肿的患者，其特征为呼吸困难、呼吸急促、心动过速、副肌干预措施：除了标准治疗外，13 名患者被随机接受经鼻 CPAP (10 cm H2O)，14 名患者被随机接受经鼻双水平气道正压通气（吸气和呼气正压气道压力分别为 15 和 5 cm H2O），自发/定时模式结合了患者流量触发和备份测量和主要结果：30 分钟后，呼吸频率（32+/-4 至 26+/-5 次/分钟）、心率（110+/-21 至 97+/-20 次/分钟）、血压（平均 117+/-28 至 92+/-18 毫米汞柱）和配速（56+/-15 至 43+/-9 托 [7.5+/-2 至在双水平气道正压通气组中观察到血压下降了 5.7+/-1.2 kPa]，动脉 pH 值和呼吸困难评分也显着改善 (p
Objective: To evaluate whether bilevel positive airway pressure, by actively assisting inhalation, more rapidly improves ventilation, acidemia, and dyspnea than continuous positive airway pressure (CPAP) in patients with acute pulmonary edema.Design: Randomized, controlled, double-blind trial.Setting: Emergency department in a university hospital.Patients: Twenty-seven patients, presenting with acute pulmonary edema, characterized by dyspnea, tachypnea, tachycardia, accessory muscle use, bilateral rales, and typical findings of congestion on a chest radiograph.interventions: In addition to standard therapy, 13 patients were randomized to receive nasal CPAP (10 cm H2O), and 14 patients were randomized to receive nasal bilevel positive airway pressure (inspiratory and expiratory positive airway pressures of 15 and 5 cm H2O, respectively) in the spontaneous/timed mode that combines patient flow-triggering and backup time-triggering.Measurements and Main Results: After 30 mins, significant reductions in breathing frequency (32+/-4 to 26+/-5 breaths/min), heart rate (110+/-21 to 97+/-20 beats/min), blood pressure (mean 117+/-28 to 92+/-18 mm Hg), and Pace, (56+/-15 to 43+/-9 torr [7.5+/-2 to 5.7+/-1.2 kPa]) were observed in the bilevel positive airway pressure group, as were significant improvements in arterial pH and dyspnea scores (p