论文部分内容阅读
急性心源性肺水肿引起的呼吸衰竭是气管插管的常见原因之一,而无创通气治疗使部分患者避免气管插管和相关的并发症.临床常用的无创通气模式是持续正压通气和无创正压通气两种,均能够改善急性心源性肺水肿患者的生命体征、生理指标,降低插管率.理论上推测,无创正压通气优于持续正压通气,但临床试验研究并没有发现无创正压通气在降低插管率和病死率方面有优势.现对持续正压通气和无创正压通气治疗急性心源性肺水肿的随机对照试验做一综述,为临床治疗提供循证依据.“,”Respiratory failure caused by acute cardiogenic pulmonary edema (ACPE) is a common reason of endotracheal intubation.In some patients intubation and its related complications can be avoided by noninvasive ventilation therapy.Both continuous positive airway pressure (CPAP) and noninvasive positive pressure ventilation (NIPPV) can improve the vital signs and physiological variables,and reduce the rate of intubation in patients with ACPE.Despite a physiological rationale that NIPPV should offer greater benefit than CPAP,NIPPV has not been found to offer any advantages in intubation rate or mortality comparing with CPAP.In this article we will review the randomized controlled trials and afford the evidence on NIPPV and CPAP in patients with ACPE.