acidemia does not affect outcomes of patients with acute cardiogenic pulmonary edema treated with continuous positive airway pressure酸血症并不影响结果的急性心原性肺水肿患者治疗持续气道正压.pdfVIP

Aliberti et al. Critical Care 2010, 14:R196 /content/14/6/R196 RESEARCH Open Access Acidemia does not affect outcomes of patients with acute cardiogenic pulmonary edema treated with continuous positive airway pressure 1* 1 2 3 2 Stefano Aliberti , Federico Piffer , Anna Maria Brambilla , Angelo A Bignamini , Valentina D Rosti , Tommaso Maraffi2 2 2 , Valter Monzani , Roberto Cosentini Abstract Introduction: A lack of data exists in the literature evaluating acidemia on admission as a favorable or negative prognostic factor in patients with acute cardiogenic pulmonary edema (ACPE) treated with non-invasive continuous positive airway pressure (CPAP). The objective of the present study was to investigate the impact of acidemia on admission on outcomes of ACPE patients treated with CPAP. Methods: This was a retrospective, observational study of consecutive patients admitted with a diagnosis of ACPE to the Emergency Department of IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy, between January 2003 and December 2006, treated with CPAP on admission. Two groups of patients were identified: subjects with acidemia (acidotic group), and those with a normal pH on admission (controls). The primary endpoint was clinical failure, defined as switch to bi-level ventilation, switch to endotracheal intubation or inhospital mortality. Results: Among the 378 patients enrolled, 290 (77%) were acidotic on admission. A total of 28 patients (9.7%) in the acidotic group and eight patients (9.1%) among controls experienced a clinical failure (odds ratio = 1.069, 95% confidence interval = 0.469 to 2.438, P = 0.875). Survival an