Noninvasive Ventilation in Pulmonary Edema Complicating Acute Myocardial Infarction
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概要
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Background: Because it remains unclear whether noninvasive ventilation (NIV) is an effective therapy for cardiogenic pulmonary edema secondary to acute myocardial infarction (AMI), we retrospectively evaluated our experience with NIV in the treatment of pulmonary edema secondary to AMI and other cardiac conditions. Methods and Results: The study group included 206 patients with cardiogenic pulmonary edema, divided into an AMI group (53 patients) and a non-AMI group (153 patients). The weaning rate from NIV was similar in the AMI and non-AMI groups (90.6% vs. 90.8%, P=0.950). Heart rate, blood pressure, and respiratory rate decreased significantly 1h after initiation of NIV in both groups, and were maintained until weaning from NIV. The frequency of endotracheal intubation after weaning from NIV was higher in the AMI group than in the non-AMI group (7.5% vs. 0.7%, P=0.016), although the overall frequency of intubation was similar in both groups. The in-hospital mortality rate was similar in the AMI and non-AMI groups (13.1% vs. 9.8%, P=0.489). Conclusions: NIV effectively improved vital signs and oxygenation and lowered the intubation rate in patients with cardiogenic pulmonary edema of all etiologies, including AMI. The outcome in patients with AMI treated with NIV depends primarily on the severity of the course of AMI and not on the severity of acute respiratory failure. (Circ J 2012; 76: 2586–2591)
- 2012-10-25
著者
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Mizuno Kyoichi
Department Of 1st Internal Medicine Nippon Medical School
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Takeda Shinhiro
Division Of Coronary Care Unit Nippon Medical School
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Tanaka Keiji
Division Of Cardiology Department Of Internal Medicine Nippon Medical School
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Sato Naoki
Division Of Biological Science Graduate School Of Science Nagoya University
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Yamamoto Takeshi
Division Of Cardiology Department Of Internal Medicine Nippon Medical School
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Akutsu Koichi
Division Of Intensive And Cardiac Care Unit Nippon Medical School Hospital
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MIZUNO Kyoichi
Department of Internal Medicine (Divisions of Cardiology, Hepatology, Geriatrics, and Integrated Medicine), Nippon Medical School Hospital
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MASE Hiroshi
Division of Intensive and Cardiac Care Unit, Nippon Medical School Hospital
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NAKAZATO Keiko
Division of Intensive and Cardiac Care Unit, Nippon Medical School Hospital
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