Introduction:

Non-invasive ventilation reduces the need for intubation and intensive care stay in cardiogenic pulmonary edema.

Objective:

To evaluate the possible relationship between the initiation of non-invasive ventilation on admission to the emergency room and mortality and the need for intubation in patients with cardiogenic pulmonary edema.

Method:

A retrospective analytical cohort study. A chart review of patients over the age of 18 hospitalized at an institution in Medellín, Colombia.

Results:

70 patients met the inclusion criteria and were compared by vital status at discharge. Survivors (49): the average age was 63 years, 34.7% were women, 57.1% had a history of chronic pulmonary disease, 89% had hypertension, 10 hours was the average for receiving the intervention, and 20% required orotracheal intubation. Non-survivors (21): the average age was 74 years, 57.1% were women, 57.1% had a history of chronic pulmonary disease, 90% had hypertension; 7 hours was the average for receiving the intervention, and 62% required intubation. Timing of initiation related to mortality on the multivariate analysis: odds ratio (OR) 1.05, 95% confidence interval (95%CI) 0.89-1.24, p = 0.499; and by instrumental variable: 7% difference in means. With regard to timing of initiation and its association with the need for intubation: OR 0.93, 95%CI 0.86-1.01.

Conclusions:

This study suggests that late initiation of non-invasive ventilation is a risk factor; however, no statistically significant association was found. Therefore, further studies are needed to confirm this finding.

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