Continuous positive airway pressure plus low flow oxygen versus usual care of severe acute cardiogenic pulmonary edema in the pre-hospital setting: A randomised controlled trial

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Congestive heart failure occurred in 5.7 million Americans. Invasive ventilation increases the risk of complications, including hospital acquired infection (HAI) (pneumonia, sinusitis) and tracheal injury, and consequently may prolong ICU and hospital stay. Despite the potential advantages of CPAP for the management of severe ACPEn Objectives Course Objective Acute cardiogenic pulmonary edema (ACPE) is characterized by acute breathlessness and hypoxia and is associated with poor prognosis. Standard pre-hospital management of ACPE includes high-flow oxygen, nitroglycerin and, in severe cases, assisted ventilation. Patients with ACPE can be supported with newer modalities of non-invasive ventilation, specifically continuous positive airway pressure (CPAP). The aim of this study was to determine whether patients with ACPE treated with CPAP plus low-flow oxygen pre-hospitally have a lower mortality rate than those treated conventionally..