Thompson J, Petrie DA, Ackroyd-Stolarz S, Bardua DJ Out-of-Hospital Continuous Positive Airway Pressure Ventilation Versus Usual Care in Acute Respiratory Failure: A Randomized Controlled Trial
Refers to article:
Out-of-Hospital Continuous Positive Airway Pressure Ventilation Versus Usual Care in Acute Respiratory Failure: A Randomized Controlled Trial
, 04 April 2008
James Thompson, David A. Petrie, Stacy Ackroyd-Stolarz, Darrell J. Bardua
Annals of Emergency Medicine
September 2008 (Vol. 52, Issue 3, Pages 232-241.e1) Abstract |
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Editor's Capsule Summary What is already known on this topic
Application of continuous positive airway pressure (CPAP) for patients with acute respiratory distress reduces the need for tracheal intubation and mechanical ventilation. Case series have demonstrated CPAP's feasibility in out-of-hospital settings.
What question this study addressed
Seventy-one out-of-hospital patients with severe respiratory distress, randomized to receive CPAP or usual care, were assessed to determine need for tracheal intubation and mortality.
What this study adds to our knowledge
Within the CPAP group, the rate of intubation was 30% less than the usual care group, and mortality was 20% lower.
How this might change clinical practice
Emergency medical services systems and their medical directors should consider making CPAP available as part of the treatment for out-of-hospital severe respiratory distress patients, particularly in systems with long transport times.
aVanderbilt University Medical Center, Nashville, TN
bVanderbilt University Medical Center, Nashville, TN
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ABSTRACT
Out-of-Hospital Continuous Positive Airway Pressure Ventilation Versus Usual Care in Acute Respiratory Failure: A Randomized Controlled Trial
) “intermediate,” (
) and “advanced” (
) so that individuals planning a journal club can assign the right question to the right student. The answers to this journal club will be published in the February 2009 issue. US residency directors will have immediate access to the answers through the Council of Emergency Medicine Residency Directors Share Point Web site. International residency directors can gain access to the questions by going to