What is the efficacy of noninvasive ventilation (NIV) for congestive heart failure (CHF)?

Updated: Jun 18, 2020
  • Author: Guy W Soo Hoo, MD, MPH; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

Noninvasive ventilation is effective in patients with CHF. CPAP is probably the most effective mode, achieving a reduction in intubation rates and mortality rates, with a little less effectiveness noted with noninvasive ventilation (BiPAP). Subsequent experience with BiPAP has not identified an increased risk with therapy, specifically no increased risk of myocardial infarction; therefore, the choice of ventilatory support may be a local or patient-based decision. Subsequent trials comparing BiPAP or its equivalent with CPAP have failed to demonstrate the superiority in patient outcomes of one mode to the other. [27] Patients with CHF who can be treated in an emergency department setting may only realize a symptom or dyspnea benefit from noninvasive ventilation (whether CPAP or BiPAP) as opposed to oxygen alone.


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