Use of a nasal continuous positive airway pressure mask in the treatment of postoperative atelectasis in aortocoronary bypass surgery.
Pulmonary oxygen transfer, defined by PaO2/FIO2, and radiologic presence of atelectasis were measured pre-, intra-, and postoperatively to postoperative day 9 in elective cardiac aortocoronary bypass surgical patients, who were randomly allocated either to receive 18 h PEEP while on the ventilator followed by 12 h of nasal continuous positive airway pressure (nasal CPAP) or to be control subjects. The two groups were comparable in age, sex, forced expiratory volume in 1 sec (FEV1), the ratio of FEV1 over forced vital capacity (FVC), time on pump, units of blood transfused, New York Heart Association grading, and cardiac performance indices. The PaO2/FIO2 was significantly (p less than .05) better from half an hour after extubation until 24 h postextubation in the nasal CPAP group, but was decreased for the remainder of the study in both groups. Incidence of atelectasis/consolidation was not different in both groups during the study period. We conclude that nasal CPAP is well tolerated as a treatment of hypoxemia in the immediate postoperative period of aortocoronary bypass patients. CPAP does not change the course of postoperative atelectasis.
Department of Surgery, University of Saskatchewan, Saskatoon, Canada.
J C
JC
Pinilla
F H
FH
Oleniuk
L
L
Tan
I
I
Rebeyka
N
N
Tanna
A
A
Wilkinson
B
B
Bharadwaj
D000368:Aged; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008397:Masks; D008875:Middle Aged; D009666:Nose; D011175:Positive-Pressure Respiration / Q000295:instrumentation* / Q000379:methods; D011183:Postoperative Complications / Q000628:therapy*; D011184:Postoperative Period; D001261:Pulmonary Atelectasis / Q000209:etiology / Q000628:therapy*; D011659:Pulmonary Gas Exchange