SHORT REPORTSPrehospital noninvasive pressure support ventilation for acute cardiogenic pulmonary edemaWeitz, Gunther; Struck, Jan; Zonak, Andrea; Balnus, Sven; Perras, Boris; Dodt, ChristophAuthor Information Department of Internal Medicine I, Conservative Intensive Care and Emergency Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany Correspondence to Professor Christoph Dodt, MD, Department of Internal Medicine I, Conservative Intensive Care and Emergency Medicine, University Hospital Schleswig Holstein, Campus Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany Tel: +49 4515002329; fax: +49 4515003663; e-mail: [email protected] Received 12 December 2006 Accepted 21 January 2007 European Journal of Emergency Medicine: October 2007 - Volume 14 - Issue 5 - p 276-279 doi: 10.1097/MEJ.0b013e32826fb377 Buy Metrics Abstract Severe acute cardiogenic pulmonary edema (ACPE) can successfully be treated with noninvasive pressure support ventilation (NIPSV) in a clinical setting. Whether prehospital NIPSV starting early at patients' home and being continued until hospital arrival is feasible and improves ACPE emergency care is examined in this study. End points of the study were oxygen saturation at hospital admission and clinical outcome. Twenty-three patients suffering from severe cardiac pulmonary edema with severe dyspnea, an oxygen saturation of less than 90% and basal rales were included in this controlled prospective randomized trial. All patients received standard medical treatment and 10 patients were additionally treated with NIPSV (pressure support level, 12 cmH2O; positive endexpiratory pressure, 5 cmH2O; FiO2, 0.6) whereas the other patients received oxygen (8 l/min) via Venturi face mask. Improvement in oxygen saturation was significantly faster in the NIPSV group and oxygen saturation was higher at the time of the hospital admission (NIPSV=97.3±0.8%; standard=89.5±2.7%, P=0.002). A trend toward higher troponin T levels was seen in the standard treatment group. The need for intensive care treatment did not differ, and one patient of each treatment group died in hospital. No complications were noted during the treatment with NIPSV. Prehospital NIPSV is feasible and able to improve emergency management of ACPE. © 2007 Lippincott Williams & Wilkins, Inc.