Clinical and Hemodynamic Effects of CPAP-Therapy in Patients with Cardiogenic Pulmonary Edema
Objective: to evaluate the clinical and hemodynamic effects of CPAP-therapy in the treatment of alveolar cardiogenic pulmonary edema (CPE) in patients with acute myocardial infarction (AMI).Subjects and methods. The open-labeled prospective study included 22 patients (19 males; mean age, 59.2±5.8 ye...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2007-02-01
|
| Series: | Общая реаниматология |
| Subjects: | |
| Online Access: | https://www.reanimatology.com/rmt/article/view/1087 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849242904875237376 |
|---|---|
| author | M. V. Gorbunova A. R. Tatarsky S. L. Babak L. A. Golubev A. G. Chuchalin |
| author_facet | M. V. Gorbunova A. R. Tatarsky S. L. Babak L. A. Golubev A. G. Chuchalin |
| author_sort | M. V. Gorbunova |
| collection | DOAJ |
| description | Objective: to evaluate the clinical and hemodynamic effects of CPAP-therapy in the treatment of alveolar cardiogenic pulmonary edema (CPE) in patients with acute myocardial infarction (AMI).Subjects and methods. The open-labeled prospective study included 22 patients (19 males; mean age, 59.2±5.8 years) with CPE that had complicated the course of AMI. Despite the drug and oxygen therapies of CPE for 30 minutes, progressive respiratory and left ventricular failures were an indication for the initiation of CPAP-therapy (7.3±1.2 cm H2O) that was performed, by employing REM-Star apparatuses (Respironics, USA) and Ultra Mirage facial masks (ResMed, Australia). Oxygen, 2 l/min (FiO2 = 40%), was delivered through the mask circuit. Central hemodynamic parameters were measured before and 60 and 180 minutes after the initiation of CPAP-therapy, by using a Swan-Ganz thermodilution cathether (HANDS OFF, model AH-05000-H, ARROW, USA). Arterial and mixed venous blood gas composition was rapidly determined on an automatic gas analyzer (Rapidlab 348, Bayer, USA).Results. Cyanosis and acrocyanosis disappeared and the number of congestive moist rales reduced in the lung in 19 (86.4%) patients during 30-min CPAP-therapy. The patients’ oxygen status changed: the value of PaO2 significantly increased (82.5±2.5 versus 57.4±4.2 mm Hg at the baseline;p<0.05); SaO2 reached the normal values 60 minutes following CPAP-therapy. There was an increase in the cardiac index (3.1±0.2 versus 2.3±0.1 l/min/m2 at the baseline; p<0.05), a decrease in pulmonary wedge pressure (14.4±21 versus 23.6±2.1 mm Hg at the baseline; p<0.05), and synchronism of right and left cardiac performance.Conclusion. CPAP-therapy optimizes treatment of patients with CPE-complicated AMI, results in the normalization of the arterial blood gas composition, significantly diminishes hydrostatic pulmonary capillary pressure, and promotes the synchronism of the right and left hearts. |
| format | Article |
| id | doaj-art-0a9d958528c7451dbe7dd478e8baae8d |
| institution | Kabale University |
| issn | 1813-9779 2411-7110 |
| language | English |
| publishDate | 2007-02-01 |
| publisher | Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia |
| record_format | Article |
| series | Общая реаниматология |
| spelling | doaj-art-0a9d958528c7451dbe7dd478e8baae8d2025-08-20T03:59:40ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102007-02-0131525610.15360/1813-9779-2007-1-52-561087Clinical and Hemodynamic Effects of CPAP-Therapy in Patients with Cardiogenic Pulmonary EdemaM. V. Gorbunova0A. R. Tatarsky1S. L. Babak2L. A. Golubev3A. G. Chuchalin4Clinical Department, Research Institute of Pulmonology, Russian Ministry of Health, MoscowClinical Department, Research Institute of Pulmonology, Russian Ministry of Health, MoscowClinical Department, Research Institute of Pulmonology, Russian Ministry of Health, MoscowClinical Department, Research Institute of Pulmonology, Russian Ministry of Health, MoscowClinical Department, Research Institute of Pulmonology, Russian Ministry of Health, MoscowObjective: to evaluate the clinical and hemodynamic effects of CPAP-therapy in the treatment of alveolar cardiogenic pulmonary edema (CPE) in patients with acute myocardial infarction (AMI).Subjects and methods. The open-labeled prospective study included 22 patients (19 males; mean age, 59.2±5.8 years) with CPE that had complicated the course of AMI. Despite the drug and oxygen therapies of CPE for 30 minutes, progressive respiratory and left ventricular failures were an indication for the initiation of CPAP-therapy (7.3±1.2 cm H2O) that was performed, by employing REM-Star apparatuses (Respironics, USA) and Ultra Mirage facial masks (ResMed, Australia). Oxygen, 2 l/min (FiO2 = 40%), was delivered through the mask circuit. Central hemodynamic parameters were measured before and 60 and 180 minutes after the initiation of CPAP-therapy, by using a Swan-Ganz thermodilution cathether (HANDS OFF, model AH-05000-H, ARROW, USA). Arterial and mixed venous blood gas composition was rapidly determined on an automatic gas analyzer (Rapidlab 348, Bayer, USA).Results. Cyanosis and acrocyanosis disappeared and the number of congestive moist rales reduced in the lung in 19 (86.4%) patients during 30-min CPAP-therapy. The patients’ oxygen status changed: the value of PaO2 significantly increased (82.5±2.5 versus 57.4±4.2 mm Hg at the baseline;p<0.05); SaO2 reached the normal values 60 minutes following CPAP-therapy. There was an increase in the cardiac index (3.1±0.2 versus 2.3±0.1 l/min/m2 at the baseline; p<0.05), a decrease in pulmonary wedge pressure (14.4±21 versus 23.6±2.1 mm Hg at the baseline; p<0.05), and synchronism of right and left cardiac performance.Conclusion. CPAP-therapy optimizes treatment of patients with CPE-complicated AMI, results in the normalization of the arterial blood gas composition, significantly diminishes hydrostatic pulmonary capillary pressure, and promotes the synchronism of the right and left hearts.https://www.reanimatology.com/rmt/article/view/1087alveolar cardiogenic pulmonary edemaacute myocardial infarctionnoninvasive lung ventilationcpap-therapy |
| spellingShingle | M. V. Gorbunova A. R. Tatarsky S. L. Babak L. A. Golubev A. G. Chuchalin Clinical and Hemodynamic Effects of CPAP-Therapy in Patients with Cardiogenic Pulmonary Edema Общая реаниматология alveolar cardiogenic pulmonary edema acute myocardial infarction noninvasive lung ventilation cpap-therapy |
| title | Clinical and Hemodynamic Effects of CPAP-Therapy in Patients with Cardiogenic Pulmonary Edema |
| title_full | Clinical and Hemodynamic Effects of CPAP-Therapy in Patients with Cardiogenic Pulmonary Edema |
| title_fullStr | Clinical and Hemodynamic Effects of CPAP-Therapy in Patients with Cardiogenic Pulmonary Edema |
| title_full_unstemmed | Clinical and Hemodynamic Effects of CPAP-Therapy in Patients with Cardiogenic Pulmonary Edema |
| title_short | Clinical and Hemodynamic Effects of CPAP-Therapy in Patients with Cardiogenic Pulmonary Edema |
| title_sort | clinical and hemodynamic effects of cpap therapy in patients with cardiogenic pulmonary edema |
| topic | alveolar cardiogenic pulmonary edema acute myocardial infarction noninvasive lung ventilation cpap-therapy |
| url | https://www.reanimatology.com/rmt/article/view/1087 |
| work_keys_str_mv | AT mvgorbunova clinicalandhemodynamiceffectsofcpaptherapyinpatientswithcardiogenicpulmonaryedema AT artatarsky clinicalandhemodynamiceffectsofcpaptherapyinpatientswithcardiogenicpulmonaryedema AT slbabak clinicalandhemodynamiceffectsofcpaptherapyinpatientswithcardiogenicpulmonaryedema AT lagolubev clinicalandhemodynamiceffectsofcpaptherapyinpatientswithcardiogenicpulmonaryedema AT agchuchalin clinicalandhemodynamiceffectsofcpaptherapyinpatientswithcardiogenicpulmonaryedema |