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《Chinese Journal of Critical Care Medicine》 2003-01
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Preliminary study on the effect of CPAP on the treatment of acute left ventricular failure

WANG Hou-li,WANG Zhong,YU Xue-zhong Emergency Department, Peking Union Medical College Hospital, Reijing 100730, China  
Objective To study the effect of continuous positive airway pressure(CPAP) on acute cardiogenic pulmonary edema.Methods 24 patients with mild and moderate acute left ventricular failure were recruited from the ER of PUMC hospital.Once the diagnosis was made,the patients were treated with CPAP of 5 cmH 2O without restriction on other medical therapy.Major physiological data were recorded after 15 minutes of CPAP therapy.Results In 15 minutes,respiratory rate dropped slightly but there was statistical significance〔(35±8) vs (33±7) P=0 001〕.Analysis of blood gas showed that PaO 2 and SaO 2 increased significantly [(56±6)vs(71±11), P 0 001;(86±6)% vs (95±5)%, P 0 001],while PaCO 2 and pH did not show any significant changes[(38±6)vs(39±5),P=0 376;(7 32±0 07)vs(7 32±0 05),P=0 245].After 15 minutes of CPAP therapy, both heart rate and mean blood pressure improved [(107±21)vs(100±23), P 0 05;(104±15)vs(85±7), P 0 001] Conclusions For patients with cardiogenic pulmonary edema,CPAP could improve oxygenation dramatically as functional residual capacity increased and ventilation/perfusion mismatch improved.This improvement could not be attributed to the increment of alveolar minute ventilation.Our observation showed that CPAP decreased the work of breath.All these were helpful to decrease the load of the left heart.Circulation improved quickly with the synthetic effect of medication and CPAP.The accurate effect of CPAP on circulation would be further investigated.
【CateGory Index】: R541.6
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