Non-Invasive Ventilation in Pulmonary Edema

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00453947
Recruitment Status : Completed
First Posted : March 29, 2007
Last Update Posted : March 29, 2007
Information provided by:
Ospedale S. Giovanni Bosco

Brief Summary:
This randomized controlled trial is primarily aimed at assessing the rate of acute myocardial infarction with the two noninvasive ventilatory techniques, non-invasive intermittent positive pressure ventilation and non-invasive continuous positive airway pressure.

Condition or disease Intervention/treatment Phase
Pulmonary Edema Myocardial Infarction Device: CPAP and Non Invasive Ventilation Phase 4

Detailed Description:

Objective: To determine whether the application of non-invasive intermittent positive pressure ventilation (n-IPPV) increases the incidence of acute myocardial infarction (AMI) in patients with acute respiratory failure (ARF) secondary to acute cardiogenic pulmonary edema (ACPE), as opposed to non-invasive continuous positive airway pressure (n-CPAP).

Background Both n-CPAP or n-IPPV are used to treat ACPE complicated by ARF. Two previous studies, however, report an increased rate of AMI associated with the use of n-IPPV.

Methods: Fifty-two patients with severe ARF consequent to ACPE were randomized to receive n-CPAP (n=27) or n-IPPV (n=25), both associated with standard medical therapy. Cardiac markers, electrocardiogram and clinical-physiological parameters were monitored at study entry, after 30 and 60 minutes, and every 6 hours for the first two days.

Study Type : Interventional  (Clinical Trial)
Enrollment : 60 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Non Invasive Positive Airway Pressure And Risk Of Myocardial Infarction In Acute Cardiogenic Pulmonary Edema: Continuous Positive Airway Pressure Vs Non Invasive Positive Pressure Ventilation
Study Start Date : July 2002
Actual Study Completion Date : May 2005

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Edema Heart Attack
U.S. FDA Resources

Primary Outcome Measures :
  1. The rate of Acute Myocardial Infarction

Secondary Outcome Measures :
  1. Rate of endotracheal intubation
  2. Mortality
  3. Time of recovery (i.e. duration of ventilatory assistance)
  4. High Dependency Unit and hospital length of stay

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • rapid onset of the symptoms
  • severe dyspnoea at rest
  • respiratory rate > 30 breaths per minute
  • use of accessory respiratory muscles
  • oxygen saturation (SpO2) inferior to 90% with an inspiratory oxygen fraction of 60% via a Venturi mask
  • radiological findings of ACPE

Exclusion Criteria:

  • acute ischemic heart disease (myocardial infarction, chest pain, ST elevation)
  • hemodynamic instability (i.e. systolic blood pressure < 90 with dopamine or dobutamine infusion ≥ 5 mcgr/Kg/min) or life-threatening arrhythmias
  • need for immediate endotracheal intubation (respiratory arrest, bradypnea or gasping)
  • inability to protect the airways
  • impaired sensorium (i.e. unconsciousness or agitation)
  • inability to clear secretions
  • respiratory tract infection
  • recent oesophageal/gastric surgery
  • gastrointestinal bleeding
  • facial deformities
  • hematological malignancy or cancer with an Eastern Cooperative Oncology Group performance status ≥ 2
  • chronic respiratory failure necessitating long-term oxygen therapy
  • diagnosis of myocardial infarction, pulmonary embolism, pneumonia, exacerbation of chronic obstructive pulmonary disease, pneumothorax in the previous 3 months
  • denial or refusal of intubation
  • claustrophobia
  • inclusion in other research protocols

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00453947

Ospedale San Giovanni Bosco Medicina d'Urgenza
Torino, Italy, 10154
Sponsors and Collaborators
Ospedale S. Giovanni Bosco
Principal Investigator: Giovanni Ferrari, MD Ospedale San Giovanni Bosco ASL4 Torino Italy

Publications automatically indexed to this study by Identifier (NCT Number): Identifier: NCT00453947     History of Changes
Other Study ID Numbers: gbosco2
First Posted: March 29, 2007    Key Record Dates
Last Update Posted: March 29, 2007
Last Verified: March 2007

Additional relevant MeSH terms:
Myocardial Infarction
Pulmonary Edema
Pathologic Processes
Myocardial Ischemia
Heart Diseases
Cardiovascular Diseases
Vascular Diseases
Signs and Symptoms
Lung Diseases
Respiratory Tract Diseases