Trial reportIntensive care medicine2011
CPAP for acute cardiogenic pulmonary oedema from out-of-hospital to cardiac intensive care unit: a randomised multicentre study.
Trial report in Intensive care medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- Noninvasive ventilation in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis of randomized controlled trials.Scientific reports · 2023Pooled it
- Adult Patients with Respiratory Distress: Current Evidence-based Recommendations for Prehospital Care.The western journal of emergency medicine · 2020Guideline
- Non-invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema.The Cochrane database of systematic reviews · 2019Pooled it
- Continuous positive airway pressure and noninvasive ventilation in prehospital treatment of patients with acute respiratory failure: a systematic review of controlled studies.Scandinavian journal of trauma, resuscitation and emergency medicine · 2014Pooled it
- Effect Modification by Acute Coronary Syndrome Prevalence on Non-Invasive Ventilation Efficacy in Acute Cardiogenic Pulmonary Edema: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of cardiovascular development and disease · 2026Review
- A clinical guide to non-invasive respiratory support in acute respiratory failure: ventilation settings, technical optimization and clinical indications.Critical care (London, England) · 2025Review
- Non-Invasive Respiratory Support for Acute Cardiogenic Pulmonary Edema in the Acute Care Setting.Current heart failure reports · 2025Review
- Initial Care Pathway in Acute Heart Failure From Home to Hospital.Clinical cardiology · 2025Review
- A Comparison of Different Guidelines for the Treatment of Acute Heart Failure and Their Extensibility to Emergency Departments: A Critical Reappraisal.Journal of clinical medicine · 2025Review
- Machine Learning for Predicting Intubations in Heart Failure Patients: the Challenge of the Right Approach.Cardiovascular drugs and therapy · 2024Article
- Utilization of Continuous Positive Airway Pressure (CPAP) by Emergency Medical Services: Updated Systematic Review and Meta-analysis.Galen medical journal · 2023Article
- Association of Non-Invasive Positive Pressure Ventilation with Short-Term Clinical Outcomes in Patients Hospitalized for Acute Decompensated Heart Failure.Journal of clinical medicine · 2021Article
- Review
- Outcomes of Patients Treated with Prehospital Noninvasive Ventilation: Observational Retrospective Multicenter Study in the Northern French Alps.Journal of clinical medicine · 2021Article
- Time-sensitive approach in the management of acute heart failure.ESC heart failure · 2021Review
- Water content of delivered gases during Helmet Continuous Positive Airway Pressure in healthy subjects.Acta bio-medica : Atenei Parmensis · 2019Article
- Heart-lung interactions, a long story with many pioneers.Annals of translational medicine · 2018Article
- Indications and practical approach to non-invasive ventilation in acute heart failure.European heart journal · 2018Review
- Prehospital treatment with continuous positive airway pressure in patients with acute respiratory failure: a regional observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2016Observational
- Management of suspected acute heart failure dyspnea in the emergency department: results from the French prospective multicenter DeFSSICA survey.Scandinavian journal of trauma, resuscitation and emergency medicine · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeContinuous positive airway pressure (CPAP) is a useful treatment for patients with acute cardiogenic pulmonary oedema (CPE). However, its usefulness in the out-of-hospital setting has been poorly investigated and only by small and single-centre studies. We designed a multicentre randomised study to assess the benefit of CPAP initiated out of hospital.
methodsA total of 207 patients with CPE were randomly allocated by emergency mobile medical units to receive either standard treatment alone or standard treatment plus CPAP. CPAP was maintained after admission to the intensive care unit (ICU). Inclusion criteria were orthopnoea, respiratory rate greater than 25 breaths/min, pulse oximetry less than 90% in room air and diffuse crackles. The primary end point was assessed during the first 48 h and combined: death, presence of intubation criteria, persistence of either all inclusion criteria or circulatory failure at the second hour or their reappearance before 48 h. Absence of all criteria defined successful treatment.
resultsCPAP was used for 60 min [40, 65] (median [Q1, Q3]) in the pre-hospital setting and 120 min [60, 242] in ICU and was well tolerated in all patients. Treatment was successful in 79% of patients in the CPAP group and 63% in the control group (p = 0.01), especially for persistence of inclusion criteria after 2 h (12 vs. 26%) and for intubation criteria (4 vs. 14%). CPAP was beneficial irrespective of the initial PaCO(2) or left ventricular ejection fraction.
conclusionImmediate use of CPAP in out-of-hospital treatment of CPE and until CPE resolves after admission significantly improves early outcome compared with medical treatment alone.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.