Extended-time of noninvasive positive pressure ventilation improves tissue perfusion after coronary artery bypass surgery: a randomized clinical trial
Rev. bras. cir. cardiovasc
; Rev. bras. cir. cardiovasc;33(3): 250-257, May-June 2018. tab, graf
Article
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| ID: biblio-958414
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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.brPalavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Ponte de Artéria Coronária
/
Respiração com Pressão Positiva
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Ventilação não Invasiva
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Pneumopatias
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Guideline
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
CARDIOLOGIA
/
CIRURGIA GERAL
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Brasil
/
Estados Unidos
País de publicação:
Brasil