Agarwal R, Aggarwal A N, Gupta D, Jindal S K
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Postgrad Med J. 2005 Oct;81(960):637-43. doi: 10.1136/pgmj.2004.031229.
Non-invasive ventilation (NIV) is the delivery of assisted mechanical ventilation to the lungs, without the use of an invasive endotracheal airway. NIV has revolutionised the management of patients with various forms of respiratory failure. It has decreased the need for invasive mechanical ventilation and its attendant complications. Cardiogenic pulmonary oedema (CPO) is a common medical emergency, and NIV has been shown to improve both physiological and clinical outcomes. From the data presented herein, it is clear that there is sufficiently high level evidence to favour the use of continuous positive airway pressure (CPAP), and that the use of CPAP in patients with CPO decreases intubation rate and improves survival (number needed to treat seven and eight respectively). However, there is insufficient evidence to recommend the use of bilevel positive airway pressure (BiPAP), probably the exception being patients with hypercapnic CPO. More trials are required to conclusively define the role of BiPAP in CPO.
无创通气（NIV）是在不使用侵入性气管内气道的情况下，向肺部输送辅助机械通气。无创通气彻底改变了各种形式呼吸衰竭患者的管理方式。它减少了对有创机械通气及其相关并发症的需求。心源性肺水肿（CPO）是一种常见的医疗急症，无创通气已被证明可改善生理和临床结局。从本文提供的数据来看，显然有足够高等级的证据支持使用持续气道正压通气（CPAP），并且在CPO患者中使用CPAP可降低插管率并提高生存率（治疗所需人数分别为7和8）。然而，没有足够的证据推荐使用双水平气道正压通气（BiPAP），可能高碳酸血症性CPO患者是个例外。需要更多试验来最终确定BiPAP在CPO中的作用。
