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
Artigo
em Inglês
| LILACS
| ID: biblio-958414
Biblioteca responsável:
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:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Saúde e Bem-Estar
Problema de saúde:
Objetivo 9: Redução de doenças não transmissíveis
/
Meta 3.4: Reduzir as mortes prematuras devido doenças não transmissíveis
Base de dados:
LILACS
Assunto principal:
Ponte de Artéria Coronária
/
Respiração com Pressão Positiva
/
Ventilação não Invasiva
/
Pneumopatias
Tipo de estudo:
Ensaio clínico controlado
/
Estudo de etiologia
/
Guia de prática clínica
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
Cardiologia
/
CIRURGIA GERAL
Ano de publicação:
2018
Tipo de documento:
Artigo
País de afiliação:
Brasil
/
Estados Unidos
Instituição/País de afiliação:
Hospital Santa Rosa/BR
/
Universidade Federal de São Paulo/BR
/
Universidade Federal do Mato Grosso/BR
/
University of Illinois Chicago/US