Comparison of effects of manual versus ventilator hyperinflation on respiratory compliance and arterial blood gases in patients undergoing mitral valve replacement.
OBJECTIVE
To compare the effects of manual hyperinflation (MHI) and ventilator hyperinflation (VHI) delivered to completely sedated and paralyzed patients undergoing mitral valve replacement (MVR) while maintaining minute ventilation.


METHODS
This was a randomized study with a 2-group, pre-test, post-test experimental design. Effects of hyperinflation were studied on static compliance (C(stat)), dynamic compliance (C(dyn)), oxygenation (Pao(2):Fio(2)), partial pressure of carbon dioxide in arterial blood (Paco(2)), and cologarithm of activity of dissolved hydrogen ions in arterial blood (pH). A sample of 30 patients in the immediate postoperative phase of MVR surgery were included in the study.


RESULTS
No significant differences were found between the groups. Significant improvements were found in oxygenation at both 1minute and 20minutes after MHI, but only at 1minute after VHI (P < .05). VHI led to improved C(dyn) (P < .05).


CONCLUSIONS
In the immediate postoperative phase of MVR, both techniques produced similar effects on respiratory compliance and oxygenation. MHI produced longer lasting improvements in oxygenation than VHI, whereas VHI produced better improvements in dynamic compliance. Paco(2) and pH were maintained by both.
Ahmed
Faizan
F
Hamdard University (Jamia Hamdard), New Delhi, India. faizanmpt@gmail.com
Shafeeq
Aamir Mohammed
AM
Moiz
Jamal Ali
JA
Geelani
Muhammed Abid
MA
D000328:Adult; D000704:Analysis of Variance; D001784:Blood Gas Analysis / Q000295:instrumentation / Q000379:methods; D002245:Carbon Dioxide / Q000032:analysis; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000451:nursing*; D006801:Humans; D008170:Lung Compliance; D008297:Male; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D010101:Oxygen Consumption; D010313:Partial Pressure; D011175:Positive-Pressure Respiration; D011184:Postoperative Period; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*; D013990:Tidal Volume; D013997:Time Factors
D002245:Carbon Dioxide