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Evaluation of the effectiveness of continuous positive airway pressure noninvasive ventilation in the treatment of acute cardiogenic pulmonary edema in the Intensive Care Unit of 175 Military Hospital
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Abstract
Objective: To describe the clinical and paraclinical characteristics and to evaluate the treatment outcomes of continuous positive airway pressure (CPAP) non-invasive ventilation in the management of acute cardiogenic pulmonary edema (ACPE).
Subjects and methods: This was a cross-sectional descriptive study combined with a prospective interventional design and longitudinal follow-up, conducted on 68 patients diagnosed with ACPE who were indicated for non-invasive ventilation using CPAP. The study was carried out at the Intensive Care Unit (ICU) of Military Hospital 175 from October 2023 to December 2024.
Results: Among 68 patients with ACPE, the mean age was 65.2 ± 12.4 years, with males accounting for 58.8%. The most common causes were pulmonary embolism (28.4%) and acute coronary syndrome (25.0%). CPAP non-invasive ventilation significantly improved clinical and respiratory parameters: the rate of severe dyspnea decreased from 35.4% to 3.6%, SpO₂ increased from 81.3% to 94.6%, heart rate decreased from 112.6 to 88.2 beats per minute, and systolic blood pressure decreased from 169.8 to 126.5 mmHg (p < 0.001). Arterial blood gas parameters also improved significantly, with increases in pH, PaO₂, and HCO₃⁻, and decreases in PaCO₂ and base excess (p < 0.01). The overall treatment success rate was high at 85.3%, and the in-hospital survival rate reached 88.2%, while intubation and mortality rates were 14.7% and 11.8%, respectively. The most common complications included skin irritation at the mask interface (61.8%), mask displacement (38.2%), and air leakage (35.3%).
Conclusion: CPAP non-invasive ventilation is an effective and safe modality in the treatment of acute cardiogenic pulmonary edema, providing significant improvements in oxygenation, ventilation, and hemodynamics, with high success and survival rates and mostly mild, manageable complications.
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Keywords
Non-invasive ventilation, acute cardiogenic pulmonary edema, continuous positive airway pressure (CPAP)
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