ROLE OF NON INVASIVE VENTILATION IN ACUTE CARDIOGENIC PULMONARY OEDEMA IN ED Dr.Narendra Rajan. T.; Dr. Srihari Cattamanchi; Dr. Nishanth Hiremath. S; Dr. Aravinth. S; Dr. T.V. Ramakrishnan Sri Ramachandra Medical College & Research Institute, Porur, Chennai – 600116. Tamil Nadu. INDIA. OBJECTIVES MATERIALS & METHODS RESULTS Dr. Narendra Rajam. T. Acute cardiogenic pulmonary edema is a common Medical Emergency. It is a leading cause of hospitalization, accounting for 6.5 million hospital days each year across the world. In- hospital mortality from acute cardiogenic pulmonary edema is high (10 to 20%), especially when it is associated with acute myocardial infarction. Noninvasive methods of ventilation can avert tracheal intubation by improving oxygenation, reducing the work of breathing, and increasing cardiac output. BACKGROUND • NIPPV was associated with greater reductions in dyspnea, heart rate, acidosis, and hypercareduction in mortality and reducing intubation rate.pnia in ED and overall • TROP T was positive in 13 patients (26.5%). • Mean BNP was 1108.08 (SD 549.39, P value 0.017). • All patients were put on NIV and ABG repeated after 1 hour, mean pH 7.386, mean pCo2 38.50, and mean HCo3 21.2239. • Four patients (8.2%) were again subjected to NIV and 14 (28.6%) were intubated within 7 days of ICU care. • Four patients developed MI after initial treatment of NIV. • About 10 patients (20.4%) died in ICU within 10 days. • Inclusion: Patients with age >16 years, clinical diagnosis of APE, pulmonary edema on chest radiograph, respiratory rate >20 breaths per minute, and arterial pH <7.35 were included. • Methodology: All patients received NIPPV for minimum of 2 hours. Repeat analyses of arterial blood gases along with pulse, respiration, oxygen saturation, andreported their degree of dyspnea on visual-analogue blood pressure after 1hour. Patients scale at recruitment and 1 hour. • End Point: Primary end point was death or intubation within 7 days. Secondary end points were dyspnea, physiological variables, length of hospital stay and death within 30 days. • Statistical Analysis: done using SPSS ver.17. • To determine whether noninvasive ventilation (NIPPV) improves survival in patients with acute cardiogenic pulmonary edema (APE) and reduce mortality and need for intubation. • Design: A Prospective, analytical study. • Setting: Accident & Emergency Department of Sri Ramachandra Medical Centre, Chennai. • Duration: 1 st January to 31 st December 2009. • A total of 49 patients included 33 males with mean age of 60.37 years. • At presentation mean RR was 34.04/min, mean SpO2 85.98%, mean HR 112.88/min, mean SBP 143.02 mm Hg, and mean DBP 96.53 mm Hg. • After 1 hour of NIV mean RR was 24.51/minute, mean SpO2 100%, mean HR 98.84/minute, mean SBP 130 mm of Hg, and mean DBP 86.98 mm of Hg. CONCLUSION IC U Stay in days 20 15 10 5 0 C um S u rvival 1.0 0.8 0.6 0.4 0.2 0.0 N o-censored Y es-censored No Y es IN TU BATED w ithin 7 days SurvivalFunctions

ROLE OF NON INVASIVE VENTILATION IN ACUTE CARDIOGENIC PULMONARY OEDEMA IN ED

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ROLE OF NON INVASIVE VENTILATION IN ACUTE CARDIOGENIC PULMONARY OEDEMA IN ED

Dr.Narendra Rajan. T.; Dr. Srihari Cattamanchi; Dr. Nishanth Hiremath. S; Dr. Aravinth. S; Dr. T.V. Ramakrishnan Sri Ramachandra Medical College & Research Institute, Porur, Chennai – 600116. Tamil Nadu. INDIA.

OBJECTIVES

MATERIALS & METHODS

RESULTS

Dr. Narendra Rajam. T.

Acute cardiogenic pulmonary edema is a common Medical Emergency. It is a leading cause of hospitalization, accounting for 6.5 million hospital days each year across the world. In-hospital mortality from acute cardiogenic pulmonary edema is high (10 to 20%), especially when it is associated with acute myocardial infarction. Noninvasive methods of ventilation can avert tracheal intubation by improving oxygenation, reducing the work of breathing, and increasing cardiac output.

BACKGROUND

• NIPPV was associated with greater reductions in dyspnea, heart rate, acidosis, and hypercareduction in mortality and reducing intubation rate.pnia in ED and overall

• TROP T was positive in 13 patients (26.5%).

• Mean BNP was 1108.08 (SD 549.39, P value 0.017).

• All patients were put on NIV and ABG repeated after 1 hour, mean pH 7.386, mean pCo2 38.50, and mean HCo3 21.2239.

• Four patients (8.2%) were again subjected to NIV and 14 (28.6%) were intubated within 7 days of ICU care.

• Four patients developed MI after initial treatment of NIV.

• About 10 patients (20.4%) died in ICU within 10 days.

• Inclusion: Patients with age >16 years, clinical diagnosis of APE, pulmonary edema on chest radiograph, respiratory rate >20 breaths per minute, and arterial pH <7.35 were included.

• Methodology: All patients received NIPPV for minimum of 2 hours. Repeat analyses of arterial blood gases along with pulse, respiration, oxygen saturation, andreported their degree of dyspnea on visual-analogue blood pressure after 1hour. Patients scale at recruitment and 1 hour.

• End Point: Primary end point was death or intubation within 7 days. Secondary end points were dyspnea, physiological variables, length of hospital stay and death within 30 days.

• Statistical Analysis: done using SPSS ver.17.• To determine whether noninvasive

ventilation (NIPPV) improves survival in patients with acute cardiogenic pulmonary edema (APE) and reduce mortality and need for intubation.

• Design: A Prospective, analytical study.• Setting: Accident & Emergency Department

of Sri Ramachandra Medical Centre, Chennai.

• Duration: 1stJanuary to 31st December 2009.

• A total of 49 patients included 33 males with mean age of 60.37 years.

• At presentation mean RR was 34.04/min, mean SpO2 85.98%, mean HR 112.88/min, mean SBP 143.02 mm Hg, and mean DBP 96.53 mm Hg.

• After 1 hour of NIV mean RR was 24.51/minute, mean SpO2 100%, mean HR 98.84/minute, mean SBP 130 mm of Hg, and mean DBP 86.98 mm of Hg.

CONCLUSION

ICU Stay in days20151050

m S

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