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Comparison of Efficacy Between Non‐Invasive Ventilation and High‐Flow Nasal Cannula Oxygen Therapy in Treating Acute Pulmonary Edema

医学 鼻插管 麻醉 插管 氧气疗法 肺水肿 急性肺水肿 重症监护室 呼吸频率 无创通气 通风(建筑) 回顾性队列研究 倾向得分匹配 前瞻性队列研究 机械通风 临床试验 吸入氧分数 水肿 重症监护 呼吸道疾病 随机对照试验
作者
Qiaoyun Huang,Jianyi Niu,Shanshan Zha,Zhenfeng He,Xueying Fan,Luqian Zhou,Rongchang Chen,L Guan
出处
期刊:Respirology [Wiley]
标识
DOI:10.1002/resp.70304
摘要

BACKGROUND AND OBJECTIVE: Non-invasive ventilation (NIV) is the first-line treatment for acute pulmonary edema (APE). However, with the development of high-flow nasal cannula oxygen therapy (HFNC), recent small-sample prospective studies have suggested comparable efficacy between HFNC and NIV in treating acute cardiogenic pulmonary edema. To further evaluate the efficacy of these two respiratory support modalities, we directly compared their outcomes using data from two public databases, aiming to provide higher-quality evidence on the differences in benefit between the treatments. METHODS: Patients diagnosed with APE and treated with NIV or HFNC were identified from the MIMIC-IV and eICU databases. Relevant demographics, vital signs, clinical outcomes, and other metrics were extracted. The primary outcome was the respiratory rate (RR) at 1 h post-treatment. The secondary outcomes were the 7-day intubation rate, 28-day mortality, and intensive care unit length of stay. RESULTS: In total, 1180 patients were included in the study (161 in the HFNC group and 1019 in the NIV group). After propensity score matching, 158 patients were included in each group for analysis. There was no statistically significant difference in the RR at 1 h post-treatment between the NIV and HFNC groups (21 vs. 22 beats/min, p > 0.05). The 7-day intubation rate was significantly lower in the NIV group (8.23%; 13/158) than in the HFNC group (28.48%; 45/158) (p < 0.001). CONCLUSIONS: In this retrospective cohort study using propensity score matching, there was no statistically significant difference in RR at 1 h post-treatment between patients treated with HFNC or NIV for APE.

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