• Alberto Belenguer-Muncharaz, Lidón Mateu-Campos, Rubén González-Luís, Bárbara Vidal-Tegedor, Amparo Ferrándiz-Sellés, Joaquín Árguedas-Cervera, Susana Altaba-Tena, Patricia Casero-Roig, and Ester Moreno-Clarí.
• Intensive Care Unit, Hospital General Universitario de Castelló, Spain; Unidad Predepartamental Medicina, Facultad Ciencias de la Salud, Universitat Jaume I de Castelló, Spain. Electronic address: belengueralberto8@gmail.com.
• Arch. Bronconeumol. 2017 Oct 1; 53 (10): 561-567.

BackgroundTo compare the application of non-invasive ventilation (NIV) versus continuous positive airway pressure (CPAP) in the treatment of patients with cardiogenic pulmonary edema (CPE) admitted to an intensive care unit (ICU).MethodsIn a prospective, randomized, controlled study performed in an ICU, patients with CPE were assigned to NIV (n=56) or CPAP (n=54). Primary outcome was intubation rate. Secondary outcomes included duration of ventilation, length of ICU and hospital stay, improvement of gas exchange, complications, ICU and hospital mortality, and 28-day mortality. The outcomes were analyzed in hypercapnic patients (PaCO2>45mmHg) with no underlying chronic lung disease.ResultsBoth devices led to similar clinical and gas exchange improvement; however, in the first 60min of treatment a higher PaO2/FiO2 ratio was observed in the NIV group (205±112 in NIV vs. 150±84 in CPAP, P=.02). The rate of intubation was similar in both groups (9% in NIV vs. 9% in CPAP, P=1.0). There were no differences in duration of ventilation, ICU and length of hospital stay. There were no significant differences in ICU, hospital and 28-d mortality between groups. In the hypercapnic group, there were no differences between NIV and CPAP.ConclusionsEither NIV or CPAP are recommended in patients with CPE in the ICU. Outcomes in the hypercapnic group with no chronic lung disease were similar using NIV or CPAP.Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

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