title: [Non-invasive ventilation after cardiac surgery. A prospective study].
abstract: OBJECTIVE
  To report our experience with non-invasive ventilation (NIV) after cardiac surgery.
  
  
  METHODS
  Prospective study of cardiac surgery patients admitted to our PICU between 2004 and 2007 who required NIV after extubation.
  
  
  RESULTS
  A total of 331 patients were admitted to the unit after cardiac surgery during this period. Of these, 159 were extubated in the operating room. NIV was introduced in 29 episodes on 26 patients. Fallot's tetralogy and AVD were the most common heart diseases, and 65% had type II respiratory failure. The respiratory problems usually involved were acute pulmonary oedema and atelectasis. Indication was elective in 70% of episodes. BiPAP Vision was the commonest ventilator used and in the S/T mode (56%).Average length of use was 64h. Average length of stay in PICU was 22 days. Nine patients required reintubation, none of them at an early stage (first 12h) which represents an efficiency of 66%. The effectiveness of NIV was related to the type of disease and inversely with the time NIV was needed. There were complications in 12 episodes. Four patients required tracheostomy, all of which were associated with previous lung disease. Survival was 100%.
  
  
  CONCLUSIONS
  NIV is effective and safe after cardiac surgery. It has very good results in respiratory failure due to atelectasis or pulmonary oedema. NIV failure in these patients is strongly associated with preoperative pulmonary sequelae secondary to heart disease. NIV indication in these patients has to be carefully evaluated.
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España. mpons@hsjdbcn.org
authors.forename: M
authors.initials: M
authors.lastname: Pons Odena
authors.forename: I
authors.initials: I
authors.lastname: Piqueras Marimbaldo
authors.forename: S
authors.initials: S
authors.lastname: Segura Matute
authors.forename: M
authors.initials: M
authors.lastname: Balaguer Argallo
authors.forename: A
authors.initials: A
authors.lastname: Palomeque Rico
mesh_terms: D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011175:Positive-Pressure Respiration; D011182:Postoperative Care; D011446:Prospective Studies; D012189:Retrospective Studies