Non-invasive positive pressure ventilation facilitates early extubation in post operative cardiac patients

ABSTRACT

To assess the use of NIPPV [non-invasive positive pressure ventilation] during weaning from mechanical ventilation in post-op patients in an ICU and compared this procedure with intermittent mandatory ventilation [IMV] by analyzing cardiac and respiratory parameters and complications. A randomized clinical trial was conducted from June 2009 to July 2010 on Post-operative surgical patients that were on IMV for more than 48 hours, who failed at 30 minutes of spontaneous breathing T-piece trial [SBT]. If failure occurred before the 30th minute, he/she was included in the group previously defined by random assignment. Patients in the experimental group were extubated and placed on NIPPV, whereas other patients [the control group] returned to IMV. Daily SBT was carried out thereafter in order to evaluate the possibility of extubation in control group. Of 60 patients who failed T-piece trials, 30 patients were placed on NIPPV and 30 on [IMV]. The ages of patients in the NIPPV and IMV groups were 45.7 +/- 18.11 and 47.10 +/- 18.45 years respectively. In both groups, ventilation time before T-piece trial was 2-3 days. Patients of the NIPPV group had a shorter stay in the ICU and in the hospital i.e., 2.93 +/- 0.785 days versus 7.4+1.11 days for IMV group. No serious complications were observed in both groups. The results of this study suggest that the combination of early extubation and NIPPV is a good alternative