Boussignac continuous positive airway pressure for the management of acute cardiogenic pulmonary edema: prospective study with a retrospective control group

Tiny Jaarsma; Iwan C C van der Horst; Wybe Nieuwland; Karin M Vermeulen; Hanka Rosman; Leon P H J Aarts; Felix Zijlstra; Maarten W N Nijsten; Willem Dieperink

doi:10.1186/1471-2261-7-40

Boussignac continuous positive airway pressure for the management of acute cardiogenic pulmonary edema: prospective study with a retrospective control group

Tiny Jaarsma, Iwan C C van der Horst, Wybe Nieuwland, Karin M Vermeulen, Hanka Rosman, Leon P H J Aarts, Felix Zijlstra, Maarten W N Nijsten, Willem Dieperink

University of Groningen, University Medical Center Groningen, Thoraxcenter, Department of Cardiology

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Continuous positive airway pressure (CPAP) treatment for acute cardiogenic pulmonary edema can have important benefits in acute cardiac care. However, coronary care units are usually not equipped and their personnel not adequately trained for applying CPAP with mechanical ventilators. Therefore we investigated in the coronary care unit setting the feasibility and outcome of the simple Boussignac mask-CPAP (BCPAP) system that does not need a mechanical ventilator.

METHODS: BCPAP was introduced in a coronary care unit where staff had no CPAP experience. All consecutive patients transported to our hospital with acute cardiogenic pulmonary edema, a respiratory rate > 25 breaths/min and a peripheral arterial oxygen saturation of < 95% while receiving oxygen, were included in a prospective BCPAP group that was compared with a historical control group that received conventional treatment with oxygen alone.

RESULTS: During the 2-year prospective BCPAP study period 108 patients were admitted with acute cardiogenic pulmonary edema. Eighty-four of these patients (78%) were treated at the coronary care unit of which 66 (61%) were treated with BCPAP. During the control period 66 patients were admitted over a 1-year period of whom 31 (47%) needed respiratory support in the intensive care unit. BCPAP treatment was associated with a reduced hospital length of stay and fewer transfers to the intensive care unit for intubation and mechanical ventilation. Overall estimated savings of approximately euro 3,800 per patient were achieved with the BCPAP strategy compared to conventional treatment.

CONCLUSION: At the coronary care unit, BCPAP was feasible, medically effective, and cost-effective in the treatment of acute cardiogenic pulmonary edema. Endpoints included mortality, coronary care unit and hospital length of stay, need of ventilatory support, and cost (savings).

Original language	English
Article number	40
Journal	BMC Cardiovascular Disorders
Volume	7
DOIs	https://doi.org/10.1186/1471-2261-7-40
Publication status	Published - 20 Dec 2007
Externally published	Yes

Keywords

Aged
Algorithms
Case-Control Studies
Continuous Positive Airway Pressure/economics
Coronary Care Units
Feasibility Studies
Female
Heart Rate
Humans
Intubation, Intratracheal/statistics & numerical data
Length of Stay/statistics & numerical data
Male
Outcome Assessment, Health Care
Oxygen/blood
Patient Transfer/statistics & numerical data
Prospective Studies
Pulmonary Edema/therapy
Retrospective Studies

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10.1186/1471-2261-7-40Licence: CC BY

Cite this

Jaarsma, T., van der Horst, I. C. C., Nieuwland, W., Vermeulen, K. M., Rosman, H., Aarts, L. P. H. J., Zijlstra, F., Nijsten, M. W. N., & Dieperink, W. (2007). Boussignac continuous positive airway pressure for the management of acute cardiogenic pulmonary edema: prospective study with a retrospective control group. BMC Cardiovascular Disorders, 7, Article 40. https://doi.org/10.1186/1471-2261-7-40

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title = "Boussignac continuous positive airway pressure for the management of acute cardiogenic pulmonary edema: prospective study with a retrospective control group",

abstract = "BACKGROUND: Continuous positive airway pressure (CPAP) treatment for acute cardiogenic pulmonary edema can have important benefits in acute cardiac care. However, coronary care units are usually not equipped and their personnel not adequately trained for applying CPAP with mechanical ventilators. Therefore we investigated in the coronary care unit setting the feasibility and outcome of the simple Boussignac mask-CPAP (BCPAP) system that does not need a mechanical ventilator.METHODS: BCPAP was introduced in a coronary care unit where staff had no CPAP experience. All consecutive patients transported to our hospital with acute cardiogenic pulmonary edema, a respiratory rate > 25 breaths/min and a peripheral arterial oxygen saturation of < 95% while receiving oxygen, were included in a prospective BCPAP group that was compared with a historical control group that received conventional treatment with oxygen alone.RESULTS: During the 2-year prospective BCPAP study period 108 patients were admitted with acute cardiogenic pulmonary edema. Eighty-four of these patients (78%) were treated at the coronary care unit of which 66 (61%) were treated with BCPAP. During the control period 66 patients were admitted over a 1-year period of whom 31 (47%) needed respiratory support in the intensive care unit. BCPAP treatment was associated with a reduced hospital length of stay and fewer transfers to the intensive care unit for intubation and mechanical ventilation. Overall estimated savings of approximately euro 3,800 per patient were achieved with the BCPAP strategy compared to conventional treatment.CONCLUSION: At the coronary care unit, BCPAP was feasible, medically effective, and cost-effective in the treatment of acute cardiogenic pulmonary edema. Endpoints included mortality, coronary care unit and hospital length of stay, need of ventilatory support, and cost (savings).",

keywords = "Aged, Algorithms, Case-Control Studies, Continuous Positive Airway Pressure/economics, Coronary Care Units, Feasibility Studies, Female, Heart Rate, Humans, Intubation, Intratracheal/statistics & numerical data, Length of Stay/statistics & numerical data, Male, Outcome Assessment, Health Care, Oxygen/blood, Patient Transfer/statistics & numerical data, Prospective Studies, Pulmonary Edema/therapy, Retrospective Studies, ouderen, algoritmen, continue positieve drukbeademing, haalbaarheidsstudie, vrouwen, hartslag, mensen, coronaire zorg, patient verplaatsing, longoedeem, retrospectieve studies, prospectieve studies, zuurstof, bloed",

author = "Tiny Jaarsma and {van der Horst}, {Iwan C C} and Wybe Nieuwland and Vermeulen, {Karin M} and Hanka Rosman and Aarts, {Leon P H J} and Felix Zijlstra and Nijsten, {Maarten W N} and Willem Dieperink",

year = "2007",

month = dec,

day = "20",

doi = "10.1186/1471-2261-7-40",

language = "English",

volume = "7",

journal = "BMC Cardiovascular Disorders",

issn = "1471-2261",

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}

Jaarsma, T, van der Horst, ICC, Nieuwland, W, Vermeulen, KM, Rosman, H, Aarts, LPHJ, Zijlstra, F, Nijsten, MWN & Dieperink, W 2007, 'Boussignac continuous positive airway pressure for the management of acute cardiogenic pulmonary edema: prospective study with a retrospective control group', BMC Cardiovascular Disorders, vol. 7, 40. https://doi.org/10.1186/1471-2261-7-40

TY - JOUR

T1 - Boussignac continuous positive airway pressure for the management of acute cardiogenic pulmonary edema

T2 - prospective study with a retrospective control group

AU - Jaarsma, Tiny

AU - van der Horst, Iwan C C

AU - Nieuwland, Wybe

AU - Vermeulen, Karin M

AU - Rosman, Hanka

AU - Aarts, Leon P H J

AU - Zijlstra, Felix

AU - Nijsten, Maarten W N

AU - Dieperink, Willem

PY - 2007/12/20

Y1 - 2007/12/20

N2 - BACKGROUND: Continuous positive airway pressure (CPAP) treatment for acute cardiogenic pulmonary edema can have important benefits in acute cardiac care. However, coronary care units are usually not equipped and their personnel not adequately trained for applying CPAP with mechanical ventilators. Therefore we investigated in the coronary care unit setting the feasibility and outcome of the simple Boussignac mask-CPAP (BCPAP) system that does not need a mechanical ventilator.METHODS: BCPAP was introduced in a coronary care unit where staff had no CPAP experience. All consecutive patients transported to our hospital with acute cardiogenic pulmonary edema, a respiratory rate > 25 breaths/min and a peripheral arterial oxygen saturation of < 95% while receiving oxygen, were included in a prospective BCPAP group that was compared with a historical control group that received conventional treatment with oxygen alone.RESULTS: During the 2-year prospective BCPAP study period 108 patients were admitted with acute cardiogenic pulmonary edema. Eighty-four of these patients (78%) were treated at the coronary care unit of which 66 (61%) were treated with BCPAP. During the control period 66 patients were admitted over a 1-year period of whom 31 (47%) needed respiratory support in the intensive care unit. BCPAP treatment was associated with a reduced hospital length of stay and fewer transfers to the intensive care unit for intubation and mechanical ventilation. Overall estimated savings of approximately euro 3,800 per patient were achieved with the BCPAP strategy compared to conventional treatment.CONCLUSION: At the coronary care unit, BCPAP was feasible, medically effective, and cost-effective in the treatment of acute cardiogenic pulmonary edema. Endpoints included mortality, coronary care unit and hospital length of stay, need of ventilatory support, and cost (savings).

AB - BACKGROUND: Continuous positive airway pressure (CPAP) treatment for acute cardiogenic pulmonary edema can have important benefits in acute cardiac care. However, coronary care units are usually not equipped and their personnel not adequately trained for applying CPAP with mechanical ventilators. Therefore we investigated in the coronary care unit setting the feasibility and outcome of the simple Boussignac mask-CPAP (BCPAP) system that does not need a mechanical ventilator.METHODS: BCPAP was introduced in a coronary care unit where staff had no CPAP experience. All consecutive patients transported to our hospital with acute cardiogenic pulmonary edema, a respiratory rate > 25 breaths/min and a peripheral arterial oxygen saturation of < 95% while receiving oxygen, were included in a prospective BCPAP group that was compared with a historical control group that received conventional treatment with oxygen alone.RESULTS: During the 2-year prospective BCPAP study period 108 patients were admitted with acute cardiogenic pulmonary edema. Eighty-four of these patients (78%) were treated at the coronary care unit of which 66 (61%) were treated with BCPAP. During the control period 66 patients were admitted over a 1-year period of whom 31 (47%) needed respiratory support in the intensive care unit. BCPAP treatment was associated with a reduced hospital length of stay and fewer transfers to the intensive care unit for intubation and mechanical ventilation. Overall estimated savings of approximately euro 3,800 per patient were achieved with the BCPAP strategy compared to conventional treatment.CONCLUSION: At the coronary care unit, BCPAP was feasible, medically effective, and cost-effective in the treatment of acute cardiogenic pulmonary edema. Endpoints included mortality, coronary care unit and hospital length of stay, need of ventilatory support, and cost (savings).

KW - Aged

KW - Algorithms

KW - Case-Control Studies

KW - Continuous Positive Airway Pressure/economics

KW - Coronary Care Units

KW - Feasibility Studies

KW - Female

KW - Heart Rate

KW - Humans

KW - Intubation, Intratracheal/statistics & numerical data

KW - Length of Stay/statistics & numerical data

KW - Male

KW - Outcome Assessment, Health Care

KW - Oxygen/blood

KW - Patient Transfer/statistics & numerical data

KW - Prospective Studies

KW - Pulmonary Edema/therapy

KW - Retrospective Studies

KW - ouderen

KW - algoritmen

KW - continue positieve drukbeademing

KW - haalbaarheidsstudie

KW - vrouwen

KW - hartslag

KW - mensen

KW - coronaire zorg

KW - patient verplaatsing

KW - longoedeem

KW - retrospectieve studies

KW - prospectieve studies

KW - zuurstof

KW - bloed

U2 - 10.1186/1471-2261-7-40

DO - 10.1186/1471-2261-7-40

M3 - Article

C2 - 18096038

SN - 1471-2261

VL - 7

JO - BMC Cardiovascular Disorders

JF - BMC Cardiovascular Disorders

M1 - 40

ER -

Boussignac continuous positive airway pressure for the management of acute cardiogenic pulmonary edema: prospective study with a retrospective control group

Abstract

Keywords

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