Table 2

Non-invasive ventilation randomised controlled trials for APO

No of subjects (location)Type of ventilation and locationMean (SD) duration of ventilationMajor outcomes*Conclusions
*Statistically significant results only: p≤0.05; comparison: intervention v standard therapy. A-a = alveolar-arterial; APO = acute pulmonary oedema; BiPAP = bilevel positive airway pressure; BP = blood pressure; CPAP = continuous positive airway pressure; COAD = chronic obstructive airways disease; Fio2 = fractional inspired oxygen; HR = heart rate; Paco2 = arterial carbon dioxide tension; Pao2 = arterial oxygen tension; PSV = pressure support ventilation; RR = respiratory rate; SBP = systolic blood pressure.
Räsänen et al2840Face CPAP v standard therapy inintensive care unitStudied until 3 hours35% v 65% treatment failure based on cardiopulmonary parametersCPAP improved gas exchange, decreased respiratory work, unloaded circulatory stress, and may decrease need for a traditional ventilator
Improved RR, HR, and rate-pressure product at 10 min and Pao2 at 10 min and 3 hours
Bersten et al5539Face CPAP v standard therapy in intensive care unit9.3 (4.9) hours0% v 35% required endotracheal tube on the basis of blood gasesCPAP resulted in physiological improvement and decreased need for endotracheal intubation
Improved RR, Paco2, pH, and Pao2/Fio2 at 30 min
Lin et al21100Face CPAP v standard therapy in coronary care unitStudied until 6 hours24% v 50% therapeutic failure at 6hrs on the basis of blood gasesCPAP resulted in physiological improvement and decreased need for intubation but no effect on mortality
Improved Pao2, A-a gradient, HR, SBP, and rate pressure product
Mehta et al5727BiPAP v CPAP both face mask in emergency departmentBiPAP 7.1 (4.7) hoursBiPAP improved RR, HR, BP, Paco2, pH, and dyspnoea significantly more than CPAP at 30 minBiPAP better than CPAP in APO but associated with higher number of myocardial infarcts
CPAP 6.4 (5.8) hours
Wood et al5627 totalNasal BiPAP v standard therapy in emergency departmentNot statedNo significant difference in intubation rateNon-invasive ventilation may delay endotracheal intubation and is associated with increased hospital mortality
10 APONo significant differences in clinical parameters between groups
6 COAD
11 other