Faut-il encore mettre en route une ventilation non invasive en cas de détresse respiratoire sur un œdème pulmonaire cardiogénique ?

Cardiogenic pulmonary edema is a very common cause of acute respiratory distress in emergency medicine. The goals of noninvasive ventilation in this indication are to rapidly improve the symptoms of acute respiratory distress and to limit the use of an invasive ventilatory support, when combined with optimal medical treatment. The five recent meta-analysis and the French consensus conference of October 2006 have positioned noninvasive ventilation as a first line therapy during cardiogenic pulmonary edema and allowed until very recently to recommend its routine use. The recent 3CPO study has modified such an analysis, even if several biases question the generalizability of its results and seem unlikely to change our practices.