Noninvasive positive pressure ventilation: effect on mortality in acute cardiogenic pulmonary edema: a pragmatic meta-analysis.

Introduction: In contrast to a series of recent meta-analyses (MAs), the 3CPO (Three Interventions in Cardiogenic Pulmonary Oedema) randomized controlled trial (RCT) reported in 2008 did not find a significant mortality benefit of noninvasive positive pressure ventilation (NPPV) in acute cardiogenic pulmonary edema (ACPE).

Objectives: This paper combines data collected in the 3CPO trial together with data from recent MAs and calculates a revised risk ratio for NPPV in ACPE. Reasons for the discrepancy in mortality estimates are identified and discussed through contrasting the methodology and results of the 3CPO trial with previous RCTs.