As a method of treatment for cardiogenic pulmonary edema, mechanical ventilation may spare ischemic myocardium and increase survival by rapidly correcting hypoxemia and acidosis, reducing respiratory work, and relieving adrenergic stimulation. In addition, positive intrathoracic pressure may improve congestive heart failure by altering left ventricular loading conditions.
Therefore, it is not surprising that mechanical ventilation is being used more and more frequently in the treatment of cardiogenic pulmonary edema. Yet, it is costly therapy that might improve survival or prolong dying. Previous studies of cardiogenic pulmonary edema have included only small numbers of mechanically ventilated patients and have not discussed them in detail.
We retrospectively analyzed 88 episodes of cardiogenic pulmonary edema treated with mechanical ventilation in order to determine which patients benefit from this treatment. From this analysis, we have developed and validated two multiple logistic regression models that predict mortality: one using information at the time mechanical ventilation is initiated, and one using this information plus information available after 24 hours of treatment.