[Continuous positive airway pressure in acute pulmonary edema. application in a general medical ward].

BACKGROUND: The application of a Continuous Positive pressure to Patient's airway (CPAP) represents one of the most important respiratory treatments during Acute Respiratory Failure (ARF) due to Acute Cardiogenic Pulmonary Edema (ACPE). Thanks to its hemodynamic and ventilatory effects, CPAP improves clinical and gasanalytic parameters and lead to a decrease of mortality and need of intubation in these patients. CPAP can be applied with different devices: ventilators, Venturi-like flow generators and Boussignac's device.

AIM: To verify and to compare effectiveness and tolerability of two different CPAP's devices (Venturi-like flow generator and Buossignac's device) in ARF due to ACPE. The study was performed in a General Medical Ward.

MATERIALS AND METHODS: 20 patients with ARF due to ACPE were randomized in two group: the first group (10 patients) received CPAP with a Venturi-like flow generator, the second group (10 patients) with Boussignac's device. At the end of CPAP treatment each patient gave a score to tolerability.

RESULTS: In each group we noted a significant (p<0.05) improvement in clinical and gasanalytic parameters since the first hour of treatment; these improvements were confirmed in following determinations and were not significantly different in the two group of patients. The Boussignac group showed a better tolerability.

CONCLUSIONS: The two CPAP's devices resulted similar in term of effectiveness. Boussignac's device has shown a better tolerability: this characteristic, together with the simple use, should stimulate the diffusion of this device where a flow generator or a ventilator are not present (outside Intensive Care Units, for example in General Medical Wards).