Control of postcardiotomy bleeding with PEEP.
One hundred consecutive patients undergoing open-heart operation were selected for investigation of the prophylactic and therapeutic use of positive-end-expiratory pressure (PEEP) to control postoperative bleeding. Five cm of PEEP was applied after placement of sternal wires. Patients who bled more than 200 ml per hour were treated with increasing increments of PEEP until hemorrhage terminated or reoperation was required. After 8 hours, the total blood loss per patient was 281 ml for the PEEP group versus 340 ml for the controls (p greater than 0.05). Other variables showed no significant differences. Fifteen patients bled an average of 406 ml (range, 242 to 991 ml) in the first hour in the intensive care unit; they formed the PEEP treatment group. In all patients bleeding decreased to less than 60 ml per hour within 3 hours. No complications of PEEP occurred, and no patient required reoperation to control hemorrhage.
D006348:Cardiac Surgical Procedures; D006470:Hemorrhage / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000517:prevention & control / Q000628:therapy