Extended-time of noninvasive positive pressure ventilation improves tissue perfusion after coronary artery bypass surgery: a randomized clinical trial
Rev. bras. cir. cardiovasc
; 33(3): 250-257, May-June 2018. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-958414
Biblioteca responsable:
BR1.1
ABSTRACT
Abstract Objective: To compare the effects of extended- versus short-time noninvasive positive pressure ventilation on pulmonary function, tissue perfusion, and clinical outcomes in the early postoperative period following coronary artery bypass surgery in patients with preserved left ventricular function. Methods: Patients were randomized into two groups according to noninvasive positive pressure ventilation intensity: short-time noninvasive positive pressure ventilation n=20 (S-NPPV) and extended-time noninvasive positive pressure ventilation n=21 (E-NPPV). S-NPPV was applied for 60 minutes during immediate postoperative period and 10 minutes, twice daily, from postoperative days 1-5. E-NPPV was performed for at least six hours during immediate postoperative period and 60 minutes, twice daily, from postoperative days 1-5. As a primary outcome, tissue perfusion was determined by central venous oxygen saturation and blood lactate level measured after anesthetic induction, immediately after extubation and following noninvasive positive pressure ventilation protocols. As a secondary outcome, pulmonary function tests were performed preoperatively and in the postoperative days 1, 3, and 5; clinical outcomes were recorded. Results: Significant drop in blood lactate levels and an improvement in central venous oxygen saturation values in the E-NPPV group were observed when compared with S-NPPV group after study protocol (P<0.01). The E-NPPV group presented higher preservation of postoperative pulmonary function as well as lower incidence of respiratory events and shorter postoperative hospital stay (P<0.05). Conclusion: Prophylactic E-NPPV administered in the early postoperative period of coronary artery bypass surgery resulted in greater improvements in tissue perfusion, pulmonary function and clinical outcomes than S-NPPV, in patients with preserved left ventricular function. Trial Registration: Brazilian Registry of Clinical trial - RBR7sqj78 - http://www.ensaiosclinicos.gov.br
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Contexto en salud:
Agenda de Salud Sostenible para las Américas
/
ODS3 - Salud y Bienestar
Problema de salud:
Objetivo 9: Enfermedades no transmisibles y salud mental
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Meta 3.4: Reducir las muertes prematuras por enfermedades no transmisibles
Base de datos:
LILACS
Asunto principal:
Puente de Arteria Coronaria
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Respiración con Presión Positiva
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Ventilación no Invasiva
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Enfermedades Pulmonares
Tipo de estudio:
Ensayo clínico controlado
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Estudio de etiología
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Guía de práctica clínica
Límite:
Anciano
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Femenino
/
Humanos
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Masculino
Idioma:
Inglés
Revista:
Rev. bras. cir. cardiovasc
Asunto de la revista:
Cardiología
/
CIRURGIA GERAL
Año:
2018
Tipo del documento:
Artículo
País de afiliación:
Brasil
/
Estados Unidos
Institución/País de afiliación:
Hospital Santa Rosa/BR
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Universidade Federal de São Paulo/BR
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Universidade Federal do Mato Grosso/BR
/
University of Illinois Chicago/US