The use of noninvasive pressure support ventilation for severe respiratory insufficiency due to pulmonary oedema

Intensive Care Med. 1999 Jan;25(1):15-20. doi: 10.1007/s001340050781.


Objective: Experimental use of noninvasive pressure support ventilation (NIPSV) in patients with severe pulmonary oedema who would have been intubated if noninvasive ventilation were not available.

Design: Open, prospective, within patients non comparative study.

Setting: Internal intensive care unit (11 beds) at a university hospital.

Patients: 29 patients with severe respiratory distress and confirmed pulmonary oedema.

Interventions: NIPSV was applied via a tight fitting face mask delivering between 13 and 24 cm H2O inspiratory airway pressure and 2 to 8 cm H2O expiratory airway pressure.

Measurements and results: One patient required endotracheal intubation. Mean plethysmographic oxygen saturation rose significantly within 30 min from 73.8+/-11 to 90.3+/-5%, while the oxygen supply was reduced from 7.3+/-3.7 to 5.1+/-3 l/min. Mean pH increased significantly (p<0.01) from 7.22+/-0.1 before NIPSV to 7.31+/-0.07 after 60 min of NIPSV. Partial pressure of carbon dioxide was 62+/-18.5 mmHg but decreased significantly within 60 min to 48.4+/-11.5 mm Hg. Heart rate and-blood pressure stabilised continuously during the observation time. Mean duration of NIPSV was 6 h 9 min (range 60 min to 24 h). There were no serious side effects. Four patients died from underlying diseases between 1 and 28 days after NIPSV.

Conclusion: NIPSV is a highly effective technique with which to treat patients with severe cardiogenic pulmonary oedema.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Masks
  • Middle Aged
  • Positive-Pressure Respiration* / methods
  • Prospective Studies
  • Pulmonary Edema / complications*
  • Pulmonary Ventilation*
  • Respiratory Insufficiency / etiology*
  • Respiratory Insufficiency / therapy
  • Treatment Outcome