Early use of non-invasive ventilation in acute heart failure to reduce catastrophic end results – a prospective study

Acute heart failure (AHF) syndromes may be accompanied by significant respiratory failure (RF) and is commonly seen in patients with acute cardiogenic pulmonary oedema (ACPE) or cardiogenic shock (CS). Use of non-invasive ventilation (NIV) has been proven to be useful in the treatment of moderate to severe RF in several scenarios. Non-invasive ventilation has shown to be effective in ACPE, by reducing both, the respiratory distress and the rate of endotracheal intubation when compared to conventional oxygen therapy, but the end-result on mortality is still less conclusive. In this article, we will highlight and discuss about the need of early NIV support in patients with AHF depending on - the early selection of patients with AHF, early application of NIV, the correct instructions and achievement of synchronization between patient and the ventilator settings and in some cases mild sedation, may prove the success of the technique.