The role of continuous positive airway pressure in acute cardiogenic edema with preserved left ventricular systolic function.

Abstract: Objective: The objective of the study was to compare the effect of continuous positive airway pressure (CPAP) in patients with acute cardiogenic pulmonary edema (ACPE) with preserved or impaired left ventricular systolic function with regard to resolution time. Methods: In a prospective, preliminary observational cohort study, 18 patients with preserved left ventricular systolic function (group A) and 18 patients with systolic heart dysfunction (group B) with ACPE underwent CPAP (10 cmH₂0) through a face mask with standard medical therapy after a morphologic echocardiographic investigation shortly before CPAP. Results: Resolution time did not differ significantly between the 2 groups of patients (64 ± 25 minutes in diastolic group vs 80 ± 33 minutes in systolic group). One patient in preserved left ventricular systolic function group required endotracheal intubation (not statistically significant). No patient died during hospital stay. Arterial blood gases improved after a trial of CPAP in both groups of patients. Conclusions: The results of this preliminary study show that resolution time is not significantly different in patients with ACPE with preserved or impaired systolic function submitted to CPAP. [Copyright &y& Elsevier]