Clinical and Haemodynamic Effects of Bi-Level Positive Airway Pressure in Patients with Decompensated Heart Failure

Abstract
Background: Heart failure is a growing problem worldwide with high degree of morbidity and mortality especially in those with dilated cardiomyopathy. We hypothesized that noninvasive bi level positive airway pressure ventilation (BIPAP) could play a crucial role in those patients.
Aim of Study: To study the effect of Non Invasive bi-level positive air way pressure (BIPAP) ventilation on the clinical, hemodynamic parameters in patients with heart failure NYHA class 3-4 due to dilated cardiomyopathy.
Patients and Methods: Forty adult patients, (18-83 years old) of both sex with decompensated heart failure and dilated cardiomyopathy (LVEF <35%) were included in the study, they were recruited from both emergency department and critical care unit of internal medicine department, Assiut university hospital. They were divided into two groups: Group A (20 patients) received the standardmedical therapy for heart failure and supported Noninvasive positive pressure ventilation (NIV) through BIPAP, while group B (20 patients) received only the standard medical therapy for heart failure with simple mask oxygen therapy.
Results: There was a statistically significant improvement in dyspnea, tachypnea (p=0.041*, 0.03 1) in the group A compared to the group B, Meanwhile there was insignificant improvement in tachycardia, and hypotension in group A compared to group B. All patients were cooperative, and only one patient from each group needed intubation, deteriorated rapidly, and died.
Conclusion: In our study, adding Noninvasive Bi Level Positive airway ventilation (BiPAP) to conventional medical treatment improved clinical, hemodynamic, parameters in dilated cardiomyopathy patients with decompensated heart failure. We concluded, “BiPAP is not only a safe adjuvant to the conventional treatment but also, it can be more advanta-geous in the management of patients with dilated cardiomy-opathy with decompensated heart failure”.