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When pressure is positive: a literature review of the prehospital use of continuous positive airway pressure.

Abstract：

BACKGROUND:Heart failure poses a significant burden of disease, resulting in 2,658 Australian deaths in 2008, and listed as an associated cause of death in a further 14,466 cases. Common in the hospital setting, continuous positive airway pressure (CPAP) therapy is a non-invasive ventilation technique used to prevent airway collapse and manage acute pulmonary edema (APO). In the hospital setting, CPAP has been known to decrease the need for endotracheal intubation in patients with APO. Therefore the objective of this literature review was to identify the effectiveness of CPAP therapy in the prehospital environment. METHODS:A review of selected electronic medical databases (Cochrane, Medline, EMBASE, and CINAHL) was conducted from their commencement date through the end of May 2012. Inclusion criterion was any study type reporting the use of CPAP therapy in the prehospital environment, specifically in the treatment of heart failure and acute pulmonary edema. References of relevant articles were also reviewed. RESULTS:The literature search located 1,253 articles, 12 of which met the inclusion criteria. The majority of studies found that the use of CPAP therapy in the prehospital environment is associated with reduced short-term mortality as well as reduced rates of endotracheal intubation. Continuous positive airway pressure therapy was also shown to improve patient vital signs during prehospital transport and reduce myocardial damage. DISCUSSION:The studies conducted of prehospital use of CPAP to manage APO have all demonstrated improvement in patient outcomes in the short term. CONCLUSION:Available evidence suggests that the use of CPAP therapy in the prehospital environment may be beneficial to patients with acute pulmonary edema as it can potentially decrease the need for endotracheal intubation, improve vital signs during transport to hospital, and improve short-term mortality.

journal_name

Prehosp Disaster Med

journal_title

Prehospital and disaster medicine

authors

Williams B,Boyle M,Robertson N,Giddings C

doi

10.1017/S1049023X12001562

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

52-60

issue

eissn

1049-023X

issn

1945-1938

pii

S1049023X12001562

journal_volume

pub_type

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When pressure is positive: a literature review of the prehospital use of continuous positive airway pressure.