Helmet continuous positive airway pressure vs. high flow nasal cannula oxygen in acute cardiogenic pulmonary oedema: a randomized controlled trial
| Autor: | Sow Kai Fei, Chan Pei Fong, Francesco Mojoli, Azma Haryaty Ahmad, Guido Tavazzi, Azlizawati Azil, Gabriele Via, Adi Osman, Roslanuddin Mohd Sallehuddin |
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| Rok vydání: | 2021 |
| Předmět: |
Respiratory rate
medicine.medical_treatment Pulmonary Edema Critical Care and Intensive Care Medicine medicine.disease_cause Hypoxemia law.invention Randomized controlled trial law Oxygen therapy Heart rate medicine Cannula Humans Intubation Continuous positive airway pressure Continuous Positive Airway Pressure business.industry General Medicine Oxygen Oxygen Saturation Anesthesia medicine.symptom Cardiology and Cardiovascular Medicine business Nasal cannula |
| Zdroj: | European Heart Journal. Acute Cardiovascular Care. 10:1103-1111 |
| ISSN: | 2048-8734 2048-8726 |
| DOI: | 10.1093/ehjacc/zuab078 |
| Popis: | Aims Non-invasive ventilation represents an established treatment for acute cardiogenic pulmonary oedema (ACPO) although no data regarding the best ventilatory strategy are available. We aimed to compare the effectiveness of helmet CPAP (hCPAP) and high flow nasal cannula (HFNC) in the early treatment of ACPO. Methods and results Single-centre randomized controlled trial of patients admitted to the emergency department due to ACPO with hypoxemia and dyspnoea on face mask oxygen therapy. Patients were randomly assigned with a 1:1 ratio to receive hCPAP or HFNC and FiO2 set to achieve an arterial oxygen saturation >94%. The primary outcome was a reduction in respiratory rate; secondary outcomes included changes in heart rate, PaO2/FiO2 ratio, Heart rate, Acidosis, Consciousness, Oxygenation, and Respiratory rate (HACOR) score, Dyspnoea Scale, and intubation rate. Data were collected before hCPAP/HFNC placement and after 1 h of treatment. Amongst 188 patients randomized, hCPAP was more effective than HFNC in reducing respiratory rate [−12 (95% CI; 11–13) vs. −9 (95% CI; 8–10), P Conclusion Amongst patients with ACPO, hCPAP resulted in a greater short-term improvement in respiratory and hemodynamic parameters as compared with HFNC. Trial registration Clinical trial submission: NMRR-17-1839-36966 (IIR). Registry name: Medical Research and Ethics Committee of Malaysia Ministry of Health. Clinicaltrials.gov identifier: NCT04005092. URL registry: https://clinicaltrials.gov/ct2/show/NCT04005092. |
| Databáze: | OpenAIRE |
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