Extended-time of noninvasive positive pressure ventilation improves tissue perfusion after coronary artery bypass surgery: a randomized clinical trial
Rev. bras. cir. cardiovasc
;
33(3): 250-257, May-June 2018. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-958414
ABSTRACT
Abstract Objective:
To compare the effects of extended- versus short-time noninvasive positive pressure ventilation on pulmonary function, tissue perfusion, and clinical outcomes in the early postoperative period following coronary artery bypass surgery in patients with preserved left ventricular function.Methods:
Patients were randomized into two groups according to noninvasive positive pressure ventilation intensity short-time noninvasive positive pressure ventilation n=20 (S-NPPV) and extended-time noninvasive positive pressure ventilation n=21 (E-NPPV). S-NPPV was applied for 60 minutes during immediate postoperative period and 10 minutes, twice daily, from postoperative days 1-5. E-NPPV was performed for at least six hours during immediate postoperative period and 60 minutes, twice daily, from postoperative days 1-5. As a primary outcome, tissue perfusion was determined by central venous oxygen saturation and blood lactate level measured after anesthetic induction, immediately after extubation and following noninvasive positive pressure ventilation protocols. As a secondary outcome, pulmonary function tests were performed preoperatively and in the postoperative days 1, 3, and 5; clinical outcomes were recorded.Results:
Significant drop in blood lactate levels and an improvement in central venous oxygen saturation values in the E-NPPV group were observed when compared with S-NPPV group after study protocol (P<0.01). The E-NPPV group presented higher preservation of postoperative pulmonary function as well as lower incidence of respiratory events and shorter postoperative hospital stay (P<0.05).Conclusion:
Prophylactic E-NPPV administered in the early postoperative period of coronary artery bypass surgery resulted in greater improvements in tissue perfusion, pulmonary function and clinical outcomes than S-NPPV, in patients with preserved left ventricular function. Trial Registration Brazilian Registry of Clinical trial - RBR7sqj78 - http//www.ensaiosclinicos.gov.br
Texto completo:
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Índice:
LILACS (Américas)
Asunto principal:
Puente de Arteria Coronaria
/
Respiración con Presión Positiva
/
Ventilación no Invasiva
/
Enfermedades Pulmonares
Tipo de estudio:
Ensayo Clínico Controlado
/
Estudio de etiología
/
Guía de Práctica Clínica
Límite:
Anciano
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Rev. bras. cir. cardiovasc
Asunto de la revista:
Cardiología
/
Cirugía General
Año:
2018
Tipo del documento:
Artículo
País de afiliación:
Brasil
/
Estados Unidos
Institución/País de afiliación:
Hospital Santa Rosa/BR
/
Universidade Federal de São Paulo/BR
/
Universidade Federal do Mato Grosso/BR
/
University of Illinois Chicago/US
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