The Cardiology Division, Saiseikai Futsukaichi Hospital, Fukuoka, Japan.
Eur J Emerg Med. 2012 Aug;19(4):267-70. doi: 10.1097/MEJ.0b013e32834ada48.
Initiating and weaning procedure of noninvasive positive pressure ventilation (NIPPV) on acute cardiogenic pulmonary edema (ACPE) has been determined empirically, and the total time of its use has been sometimes prolonged unnecessarily. A simple protocol for its use may facilitate initiation and avoids prolongation of the NIPPV treatment. We designed a step-wise protocol for NIPPV use and retrospectively examined the clinical outcome of our protocol for initiation and weaning of NIPPV in 45 patients with ACPE. Almost all patients recovered from respiratory distress successfully. There was no intubation nor complication related to NIPPV. In most of the cases, maximal-end expiratory pressure was less than 7-cm H2O. The mean duration of NIPPV was 19.5±28.0 h and the median duration was 8.0 h (interquartile range=14.0 h). This simple step-wise NIPPV protocol for ACPE can facilitate quick and safe initiation and termination of the treatment.
在急性心源性肺水肿（ACPE）中，无创正压通气（NIPPV）的启动和撤机程序是经验性确定的，其使用总时间有时不必要地延长。使用 NIPPV 的简单方案可以促进启动并避免延长 NIPPV 治疗。我们设计了一个逐步方案用于 NIPPV 的使用，并回顾性地检查了我们的 45 例 ACPE 患者的 NIPPV 启动和撤机的方案的临床结果。几乎所有患者都成功地从呼吸窘迫中恢复。没有插管也没有与 NIPPV 相关的并发症。在大多数情况下，最大呼气末压小于 7cmH2O。NIPPV 的平均持续时间为 19.5±28.0 小时，中位数持续时间为 8.0 小时（四分位间距=14.0 小时）。这种用于 ACPE 的简单逐步 NIPPV 方案可以促进治疗的快速和安全启动和终止。
