Benefits of non-invasive ventilation after extubation in the postoperative period of heart surgery.
OBJECTIVE
to show the benefits of the use of non-invasive positive pressure ventilation (NPPV) in the process of weaning from mechanical ventilation in the immediate postoperative period of heart surgery.


METHODS
A prospective, randomized and controlled study was performed involving 100 consecutive patients submitted to coronary artery bypass grafting or valve surgery. The subjects were admitted into the Intensive Care Unit (ICU) under mechanical ventilation and randomized in a study group (n=50), which used NPPV with bilevel pressure for 30 minutes after extubation, and a control group (n=50) which only used a nasal O2 catheter. Anthropometric variables and the times of the intra-operative periods corresponding to anesthesia, surgery and cardiopulmonary bypass, as well as the time required for weaning from invasive mechanical ventilation were analysed. The arterial blood gases and hemodynamic variables were also assessed before and after extubation.


RESULTS
The evolution was similar for the control and study groups without statistically significant differences of the variables analyzed except for the PaO2. On comparing the groups, the PaO2 improved significantly (p = 0.0009) with the use of NPPV for 30 minutes after extubation, but there was no statistically significant difference in the PaCO2 (p = 0.557).


CONCLUSIONS
The use of NPPV for 30 minutes after extubation improved oxygenation in the immediate postoperative period of heart surgery.
Lopes
Célia Regina
CR
FMUSP, Docente do Curso de Mestrado em Fisioterapia pelo Centro Universitário do Triângulo. tsila@uol.com.br
Brandão
Carlos Manuel de Almeida
CM
Nozawa
Emília
E
Auler
José Otávio Costa
JO
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000758:Anesthesia; D001784:Blood Gas Analysis; D015992:Body Mass Index; D001026:Coronary Artery Bypass; D020878:Device Removal; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000592:standards*; D011184:Postoperative Period; D011446:Prospective Studies; D013997:Time Factors; D015300:Ventilator Weaning / Q000379:methods*; D055815:Young Adult