3CPO Trial Summary: Noninvasive Ventilation in Pulmonary Edema

3CPO trial bipap in cardiogenic pulm edema

2008 3CPO TRIAL Noninvasive Ventilation in Acute Cardiogenic Pulmonary Edema multicenter, open, prospective, randomized, controlled trial Objective: To determine whether noninvasive ventilation reduces mortality and whether there are important differences in outcome associated with the method of treatment (CPAP or NIPPV). 1069 Inclusion criteria: patients > 16 years with clinical acute cardiogenic pulmonary edema, pulmonary edema noted on CXR, a respiratory rate of > 20 breaths per minute, and pH <7.35. patients 0 VS standard 02 therapy (n = 367) CPAP or NIPPV (n = 702) PRIMARY OUTCOME 9.8 Death within 7 days % 0.97; 95% CI, 0.63 to 1.48; P=0.87 9.5 SECONDARY OUTCOME 2.8 Intubation within 7 days % 1.05; 95% CI, 0.49 to 2.27; P=0.90 2.9 3.9 Dyspnea score – mean change after 1 hour P=0.008 4.6 Conclusion: In patients with acute cardiogenic pulmonary edema, noninvasive ventilation induces a more rapid improvement in respiratory distress and metabolic disturbance than does standard oxygen therapy but has no effect on short-term mortality. Alasdair Gray et al. NEJM, 2008; 359:142-151