Saturday, July 20, 2019

Meta-analysis: Noninvasive Ventilation in Acute Cardiogenic Pulmonary Edema

Link to the Abstract

This happens every single day at every shop I’ve worked at. Patient comes in with a CHF exacerbation sucking wind. You feel you have a little bit of wiggle room and don’t have to intubate them, while at the same time they’re too sick for nasal cannula or high flow. What do you reach for? The “BiPAP” machine! Now, just for clarification, the nomenclature is all wonky for this machine and its settings which is a different post all in itself. BiPAP is when you have a difference between the IPAP and EPAP settings while CPAP is when the IPAP and EPAP settings are the same. Being a good clinician; #physician or #respiratorytherapist, what you need to do is spend some time at the bedside hanging out with your patient to make sure you find the sweet spot that’s comfortable for them. Sometimes it’s easy, sometimes it’s impossible and they need to be intubated. This meta-analysis shows that pts who get placed on the #CPAP setting do better than those placed on #BiPAP setting with decreased mortality. A 🎩 tip to the authors.

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