[Using noninvasive positive pressure (mask) pulmonary ventilation in patients with acute myocardial infarction]

Abstract

As of now, medical therapy for acute heart failure has achieved considerable clinical results. Nevertheless, the treatment of cardiogenic pulmonary edema (CPE) and respiratory failure remain unsolved problems, complicate the course of disease, and increase mortality among patients with acute myocardial infarction (AMI). Hospital mortality due to acute heart failure ranges from 4% and runs up to 36% in artificial ventilation-requiring situations. Noninvasive respiratory support in various modes, such as continuous positive airway pressure, pressure support ventilation (PSV), and PSV + positive end-expiratory pressure (PEEP), is an effective method for the treatment of standard medical therapy-refractory CPE in patients with AMI. Noninvasive ventilation (NV) shows clinical improvement and positive changes in the parameters of not only hemodynamics, but also gas exchange. The efficiency of various NV modes and the nature of their action on such indices, such as respiratory movement rate, heart rate, mean pulmonary artery pressure, pulmonary artery wedge pressure, peripheral tissue oxygen delivery index, pO2a, pulmonary artery pO2, and Qs/Qt, have proved similar. There is a difference in the impact of PSV and PSV+PEEP on the increase in the left ventricular stroke output index and on the reduction in arterial blood CO2 tension.