[Treatment of isolated postoperative respiratory complications by constant positive pressure in spontaneous ventilation].
Positive pressure at the end of expiration (PEEP) applied in spontaneous ventilation (CPAP) has the same ventilatory effects as in controlled ventilation without the harmful actions. Few studies have described the use of CPAP in severe isolated postoperative respiratory insufficiency. CPAP was applied in 16 patients free of chronic bronchopulmonary disease, aged between 22 and 82 years, and suffering after major thoracic and/or abdominal surgery from isolated acute respiratory insufficiency as defined by clinical, blood gas and rediological criteria. CPAP was applied with mask alone (n = 5) or by nasotracheal intubation followed by mask (n = 11). PEEP was regulated at +1.7 to +2.94 KPa (+ 12 to 30 cm H2O) in order to obtain a PaO2/FIO2 greater than or equal to 300. Alveolar ventilation was assessed by capnography. Improvement was marked in six days : the PaO2/FIO2 ratio at nil PEEP fell from 129 +/- 3.2 to 3.73 +/- 6.5 (mean +/- SD), the score of interstitial and alveolar opacities from 25 to 4 and the atelectasis score from 10 to 1. These results show the efficacy of CPAP in the early treatment of isolated postoperative acute respiratory insufficiency.
D006801:Humans; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*
Traitement des complications respiratoires post-opératoires isolées par l'usage d'une pression positive permanente en ventilation spontanée.