J'ai la meme impression que Julie On Tue, Sep 2, 2008 at 1:02 PM, Julie Boyer <[EMAIL PROTECTED]> wrote:
> En effet, c'est surprenant. > > Les patients qui tolèrent sont tellement plus relax, plus rapidement avec > le BiPap. En plus, la majorité tolère bien. J'ai toujours eu l'impression > que le Bipap prévenait l'intubation…. Peut-être que l'on traite le docteur > ??? Les patients ont l'air mieux. > > Julie > > > > *From:* Alain Vadeboncoeur [mailto:[EMAIL PROTECTED] > *Sent:* Tuesday, September 02, 2008 10:01 AM > *To:* [EMAIL PROTECTED] > *Subject:* URG-L: FW: InfoPOEM: CPAP and NIPPV no better than O2 in acute > pulmonary edema (3CPO) > > > > FAscinant quand même! > > > > ALain > > > ------------------------------ > > *From:* [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] *On Behalf Of *"Équipe > éditoriale de amc.ca" > *Sent:* 2 septembre 2008 05:21 > *To:* [EMAIL PROTECTED] > *Subject:* InfoPOEM: CPAP and NIPPV no better than O2 in acute pulmonary > edema (3CPO) > > Pour assurer la livraison de ce courriel dans votre boîte de réception, > veuillez ajouter [EMAIL PROTECTED] <[EMAIL PROTECTED]> à votre carnet de > contacts. > > > *CPAP and NIPPV no better than O2 in acute pulmonary edema (3CPO)* > > *Clinical question * > Does noninvasive ventilation improve outcomes in patients with acute > cardiogenic pulmonary edema? > > *Bottom line * > In patients with acute cardiogenic pulmonary edema, continuous positive > airway pressure (CPAP) and noninvasive positive pressure support (NIPPV) do > not reduce mortality or the risk of requiring intubation more than standard > oxygen therapy. They may provide a small benefit in terms of greater relief > of dyspnea. (LOE = 1b) <http://mailer.cma.ca/t/3129055/234493/102001/0/> > > *Reference * > Gray A, Goodacre S, Newby DE, et al, for the 3CPO Trialists. Noninvasive > ventilation in acute cardiogenic pulmonary edema. N Engl J Med > 2008;359(2):142-151. <http://mailer.cma.ca/t/3129055/234493/822001/0/> > > *Study design* > Randomized controlled trial (nonblinded) > > *Funding* > Government > > *Allocation* > Concealed > > *Setting* > Inpatient (any location) > > ** > > * Obtenez des crédits > Mainpro <http://mailer.cma.ca/t/3129055/234493/822251/0/>* > > ** > > * Discutez de cet > InfoPOEM <http://mailer.cma.ca/t/3129055/234493/822226/0/>* > > ** > > * Archives <http://mailer.cma.ca/t/3129055/234493/145011/0/>* > > ** > > * Bilan des crédits <http://mailer.cma.ca/t/3129055/234493/177011/0/>* > > ** > > * Plus de FMC / DPC <http://mailer.cma.ca/t/3129055/234493/3021/0/>* > > > > <http://mailer.cma.ca/t/3129055/234493/45002/0/> > Publicité > > > > ** > > * Envoyez-nous vos commentaires <[EMAIL PROTECTED]>* > > *Synopsis * > The optimal approach to noninvasive ventilation for patients with acute > cardiogenic pulmonary edema remains unclear, with only a few small > randomized controlled trials. CPAP provides the same level of positive > airway pressure throughout the respiratory cycle, while NIPPV increases > pressure more during inspiration than during expiration. There are > theoretical reasons to think that NIPPV may be better, but it has also been > associated with a greater risk of acute myocardial infarction. In this > study, 1069 adults with acute cardiogenic pulmonary edema at 26 United > Kingdom emergency departments were randomized to receive oxygen therapy, > CPAP, or NIPPV. All patients had pulmonary edema on chest x-ray, a pH of > less than 7.35, and a respiratory rate greater than 20 breaths per minute. > Their mean age was 78 years and 57% were women. All patients received the > assigned treatment for at least 2 hours, with the duration of further > treatment determined by the treating physician. Groups were balanced at the > start of the study and analysis was by intention to treat. Overall adherence > to the assigned treatment was good, although patients initially assigned to > oxygen were more likely to change therapy because of respiratory distress > (8.4% vs 1.4% for CPAP and 3.4% for NIPPV; P < .001), while those assigned > to NIPPV were more likely to change therapy because of patient discomfort > (8.4% vs 5.2% for CPAP and 0.3% for oxygen; P < .001). After 7 days, there > was no significant difference between groups regarding rates of mortality or > need for intubation, or regarding mortality at 30 days. Patients receiving > CPAP or NIPPV had a greater improvement on a 10-point dyspnea score than > those receiving oxygen alone (4.6 vs 3.9 points), but this difference is of > questionable clinical significance. There were also greater improvements in > arterial pCO2 and pH, but again the clinical significance is uncertain. > > *Discutez de cet InfoPOEM<http://mailer.cma.ca/t/3129055/234493/822226/0/> > * > > *Archives* > InfoPOEMs (contenu anglais)<http://mailer.cma.ca/t/3129055/234493/145011/0/>| > CLIPs > (contenu anglais) <http://mailer.cma.ca/t/3129055/234493/322001/0/> | Critique > et pratique <http://mailer.cma.ca/t/3129055/234493/177003/0/> > > *Ressources cliniques* > Accueil <http://mailer.cma.ca/t/3129055/234493/94016/0/> | > Manuels<http://mailer.cma.ca/t/3129055/234493/177004/0/>| > Revues <http://mailer.cma.ca/t/3129055/234493/177005/0/> | Information > médicaments <http://mailer.cma.ca/t/3129055/234493/145012/0/> | Tests de > laboratoire <http://mailer.cma.ca/t/3129055/234493/128015/0/> | > InfoPOEMs<http://mailer.cma.ca/t/3129055/234493/145011/0/>| Guide > de pratique clinique <http://mailer.cma.ca/t/3129055/234493/177006/0/> | > Documents > d'information pour les > patients<http://mailer.cma.ca/t/3129055/234493/177007/0/>| Bibliothécaire > de l'AMC <http://mailer.cma.ca/t/3129055/234493/147004/0/> > > *Raccourcis* > MD Consult <http://mailer.cma.ca/t/3129055/234493/145015/0/> | > STAT!Ref<http://mailer.cma.ca/t/3129055/234493/148015/0/>| > [EMAIL PROTECTED] <http://mailer.cma.ca/t/3129055/234493/177008/0/> | OVID > Medline <http://mailer.cma.ca/t/3129055/234493/145016/0/> | Revues > EBSCO<http://mailer.cma.ca/t/3129055/234493/145014/0/>| > JAMC <http://mailer.cma.ca/t/3129055/234493/177009/0/> | Essential > Evidence Plus <http://mailer.cma.ca/t/3129055/234493/138018/0/>| MedCalc > 3000 <http://mailer.cma.ca/t/3129055/234493/177010/0/> > > *FMC / DPC* > Voir les cours en ligne <http://mailer.cma.ca/t/3129055/234493/3021/0/> | > Bilan > des crédits <http://mailer.cma.ca/t/3129055/234493/177011/0/> > > *Gestion de la pratique* > Accueil <http://mailer.cma.ca/t/3129055/234493/77020/0/> | Créez un site > Web de pratique <http://mailer.cma.ca/t/3129055/234493/140/0/> | Clinique > informatisée <http://mailer.cma.ca/t/3129055/234493/234014/0/> | > Bureau<http://mailer.cma.ca/t/3129055/234493/234015/0/>| Dotation > en personnel <http://mailer.cma.ca/t/3129055/234493/234016/0/> | > Finances<http://mailer.cma.ca/t/3129055/234493/234017/0/>| Juridique > et vie privée <http://mailer.cma.ca/t/3129055/234493/234018/0/> > > POEMs veut dire "Patient-Oriented Evidence that Matters". > > Désirez-vous changer le format de vos courriels d'InfoPOEMs quotidiens ou > votre adresse courriel de la liste d'InfoPOEMs quotidiens? > Gérez vos options d'InfoPOEMs > quotidiens<http://mailer.cma.ca/t/3129055/234493/3026/0/>à partir du site Web > amc.ca. > Cliquez ici pour vous > désabonner<http://mailer.cma.ca/u?id=234493.2ee32010d4b1d8089bbf2b767ebd5713&o=3129055&u=http://www.cma.ca/index.cfm/ci_id/324/la_id/2.htm&w=F&a=T&c=F&l=poem>. > > > Copyright (c) 1995-2008 InfoPOEM, Inc. > www.infopoems.com<http://mailer.cma.ca/t/3129055/234493/3013/0/>. > Tous droits réservés. > Copyright (c) 2008 Association Médicale Canadienne, Tous droits réservés. > >
