- WEDNESDAY, July 9 (HealthDay News) — Assisted breathing improves
the symptoms of patients whose lungs fill with water because of a weak
heartbeat, but it doesn't reduce death rates, a new British study
shows.

The study found no significant difference between two forms of assisted
breathing — continuous positive airway pressure (CPAP) and noninvasive
intermittent positive-pressure ventilation (NIPPV). Both deliver more air
to the lungs through face masks — CPAP continuously, NIVVP in an
on-and-off fashion.

The study, led by physicians at the University of Edinburgh, included
1,069 people, average age 77, hospitalized with what is formally called
cardiogenic pulmonary edema — accumulation of fluid in the lungs due to a
weak heartbeat.

Standard treatment in such cases concentrates on improving heart
function, said Dr. Arnold Baas, a cardiovascular disease specialist at the
University of California, Los Angeles. Many patients also get oxygen
through nose tubes.

“Lots of small studies suggested that a noninvasive breathing support
mechanism might be of benefit,” Baas said. “This is the largest randomized
trial showing whether pushing air into the lungs might help.”

In the British study, reported in the July 10 issue of the New
England Journal of Medicine, one-third of the participants got
conventional oxygen therapy, one-third were given CPAP, and one-third
received NIVVP.

“The long and short of it is that they showed these interventions
improved symptoms and blood chemistry but didn't help patients live
longer,” Baas said.

People getting either of the assisted breathing treatments reported
less shortness of breath and had better heartbeats and fewer blood
abnormalities than those getting conventional oxygen therapy. But deaths
during the seven days of treatment were about the same for those getting
conventional oxygen therapy (9.8 percent of patients) and those with
assisted breathing (9.5 percent).

The percentage of those getting assisted breathing who died or required
more serious intervention in those seven days was about the same for CPAP
(11.7 percent) and NIVVP (11.1 percent).

The improvement in symptoms means that assisted breathing is worth
using for pulmonary edema, Baas said. “It did make people feel more
comfortable,” he noted.

Both methods are readily available in hospitals, Baas said, but CPAP
probably is preferable because it is in wider use by people with sleep
apnea, who can do it at home, he explained.

More information

Pulmonary edema and its treatment are described by the U.S. Library of Medicine.