Tyler Barrett
Last active: 1/20/2015

Annals of Emergency Medicine Journal Club. Out-of-hospital continuous positive airway pressure ventilation versus usual care in acute respiratory failure: a randomized controlled trial.

Brywczynski JJ, Brywczynski JJ, Barrett TW, Schriger DL
Ann Emerg Med. 2008 52 (3): 242-3

PMID: 18722248 · DOI:10.1016/j.annemergmed.2008.07.004

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.

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