[Efficacy of the Boussignac continuous positive airway pressure device in patients with acute respiratory failure attended by an emergency medical service: a randomized clinical trial].

OBJECTIVES

To assess the efficacy of the Boussignac continuous positive airway pressure (CPAP) device for treating patients with acute respiratory failure transported by an emergency medical service.

MATERIAL AND METHODS

Retrospective, descriptive study of a series of patients treated with the Boussignac CPAP system by emergency medical service responders in Asturias between February 1, 2006, and March 19, 2012. We recorded demographic data, diagnosis, techniques and drugs used, technique failure and reasons, vital constants, (heart rate [HR], respiratory frequency [RF], systolic and diastolic blood pressures, and arterial oxygen saturation by pulse oximetry [SpO2]) at 5 times during the event (on contact without oxygen therapy in place, with conventional oxygen therapy, 5 and 15 minutes after starting CPAP, and on hospital transfer), and the duration of prehospital care.

RESULTS

A total of 203 patients with a mean (SD) age of 74.5 (10.6) years were enrolled; 133 (65.5%) were men. One hundred five (81.3%) had acute heart failure. The device failed in 28 patients (13.8%), 13 (6.4%) of whom required intubation. One (0.5%) died while still in prehospital care. All vital constants improved with CPAP. SpO2 values increased at all 5 recording times (P<.001); HR and RF improved significantly at 5 and 15 minutes of CPAP and on transfer (P<.001). Systolic and diastolic pressures were significantly lower than baseline after 15 minutes of CPAP and on transfer. Duration of care was significantly longer in patients who did not tolerate CPAP and in patients who were intubated (P<.001).

CONCLUSION

Most patients tolerated treatment with the Boussignac CPAP device and improved clinically. Few required intubation and mortality was very low.