Emergency Medicine Journal 2009;26:75
© 2009 BMJ Publishing Group Ltd and the College of Emergency Medicine.
EMQ ANSWERS
For questions on page
7
| The first 150 words of the full text of this article appear below. |
ANSWER 1
- True. Numerous studies have demonstrated that non-invasive ventilation (NIV) improves symptoms, physiological measurements and reduces intubation rates when compared with standard therapy alone.1–4
- False. The 3CPO trial failed to demonstrate a survival benefit.5 These findings are quite different from a meta-analysis published in 2005,6 which suggested a nearly 50% reduction in mortality with NIV compared with controls. However, all but two of the studies enrolled less than 100 patients. The 3CPO study enrolled more patients than all of the earlier trials combined.
- False. There is no evidence that this is true in patients with acute pulmonary oedema.6 However, most continuous positive airway pressure (CPAP) machines can deliver an FiO2 of 1.0, whereas most low-cost bilevel positive airway pressure (BiPAP) machines cannot.
- False. Although both nitrates and positive pressure ventilation will reduce preload, this does not prevent them being commenced simultaneously in patients who are not hypotensive. The 3CPO trial actively
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