title: Noninvasive Positive-Pressure Ventilation in Treatment of Hypoxemia After Extubation Following Type-A Aortic Dissection.
abstract: OBJECTIVE
  To assess the efficacy of noninvasive positive-pressure ventilation (NPPV) in improving hypoxemia after extubation for Stanford type-A aortic dissection and to compare NPPV using a mask or a helmet.
  
  
  METHODS
  Prospective, interventional study.
  
  
  METHODS
  Department of Cardiac Surgery of the Beijing Anzhen Hospital, a tertiary university hospital.
  
  
  METHODS
  Patients experiencing hypoxemia within 24 hours after extubation for Stanford type-A aortic dissection.
  
  
  METHODS
  The patients were divided into the following 3 groups: high-flux inhalation of oxygen with a Venturi mask (control patients), NPPV with a mask (mask group), and NPPV with a helmet (helmet group) (n = 25/group).
  
  
  RESULTS
  Data for blood gas analysis, vital signs, heart function, and complications were collected before the treatment, after 1 and 6 hours of treatment, and at the end of treatment. The oxygen partial pressure/fraction of inspired oxygenation index or PaO2/FIO2ratio and the oxygen partial pressure were higher and carbon dioxide partial pressure was lower in the mask and helmet groups compared with that of control patients. Compared with control patients and the mask group, the helmet group showed a slower heart rate, lower average arterial pressure, and improved left ventricular ejection fraction, leading to a lower incidence of reintubation and a shorter hospital stay.
  
  
  CONCLUSIONS
  NPPV with a helmet may quickly improve oxygen partial pressure, decrease carbon dioxide partial pressure, decrease the reintubation rate, and effectively shorten the hospital stay after extubation for Stanford type-A aortic dissection.
authors: Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors: Yi
authors: Y
authors: Yang
authors: Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China. Electronic address: 1135189276@qq.com.
authors: Nan
authors: N
authors: Liu
authors: Department of Cardiovascular Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors: Lizhong
authors: L
authors: Sun
authors: Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors: Ye
authors: Y
authors: Zhou
authors: Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors: Yong
authors: Y
authors: Yang
authors: Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors: Wei
authors: W
authors: Shang
authors: Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors: Xiaomi
authors: X
authors: Li
mesh_terms: D060666:Airway Extubation; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D005260:Female; D006260:Head Protective Devices; D006801:Humans; D000860:Hypoxia / Q000628:therapy*; D007902:Length of Stay; D008297:Male; D008397:Masks; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000295:instrumentation* / Q000379:methods; D011183:Postoperative Complications / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Stanford type-A aortic dissection; continuous positive airway pressure; helmet; hypoxemia; noninvasive positive-pressure ventilation