Treatment of Acute Respiratory Failure in Cardiogenic Pulmonary Edema

Acute respiratory failure arising in the setting of cardiogenic pulmonary edema represents a distinct clinical scenario requiring a targeted, guideline-driven approach. The underlying haemodynamic cause of the pulmonary fluid accumulation directly shapes the choice of respiratory support.

Clinical Scenario

This protocol applies to patients presenting with acute respiratory failure in the context of cardiogenic pulmonary edema — where excess fluid in the alveolar and interstitial spaces is driven by elevated cardiac filling pressures rather than a primary pulmonary process.

Treatment Approach

Evidence-based management centres on a specific non-invasive positive airway pressure modality, as recommended by international respiratory society guidelines for this patient population.

The complete regimen — including mode selection, settings, and escalation criteria — is detailed in the full protocol.

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References

DOI: 10.1186/s40560-023-00658-3

The European Respiratory Society (ERS)/ATS guidelines recommend bilevel positive airway pressure (bilevel-PAP) for patients with acute exacerbation of COPD accompanied by acute hypercarbia, CPAP for cardiogenic pulmonary edema, and NPPV for post-operative setting and early ARF in immunosuppressed patients.

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