Noninvasive ventilation and acute heart failure syndrome

Abstract

Noninvasive ventilation (NIV) is a modality of ventilatory support without endotracheal intubation and sedation and is usually delivered through a face mask, sometimes through a helmet, and infrequently through a nasal mask. It is now recognized as a very simple and efficient treatment of acute pulmonary edema due to acute heart failure (AHF), and it is also nondeleterious and associated with a low cost/effectiveness ratio. The effect of positive airway pressure is rapid and sometimes spectacular, even in case of hypercapnia and severe acute pulmonary edema. Surprisingly, NIV is not yet widely used in the intensive care unit and emergency department for this indication, possibly because it is erroneously believed that NIV is a complicated technique requiring a specialist, such as for acute respiratory failure in chronic obstructive pulmonary disease (COPD). Nowadays, some techniques of NIV do not require more than 1 hour of training, and can be used by every physician and nurse in treating patients suffering from acute heart failure and pulmonary edema. © 2008 Springer-Verlag London.