OBJECTIVE: To compare the effects of different levels of positive end-expiratory pressure on respiratory mechanics and oxygenation indexes in the immediate postoperative period of coronary artery bypass grafting. METHODS: Randomized clinical trial in which 136 patients underwent coronary artery bypass grafting between January 2011 and March 2012 were divided into three groups and admitted tomechanical ventilation with different positive end-expiratory pressure levels: Group A, 5 cmH2O (n=44), Group B, 8 cmH2O (n=47) and Group C, 10 cmH2O (n=45). Data about respiratory mechanics were obtained from mechanical ventilator monitor and oxygenation indexes from arterial blood gas samples, collected twenty minutes after intensive care unit admission. Patients with chronic obstructive pulmonary disease and patients submitted to off-pump, emergency or combined operations were not included. For statistical analysis, we used Kruskal-Wallis, G and Chi-square tests, considering results significant when P<0.05. RESULTS: Groups were homogeneous in terms of demographic, clinical and surgical variables. Patients ventilated with positive end-expiratory pressure of 10 cmH2O (Group C) had best compliance (P=0.04) and airway resistance values, this, however, without statistical significance. They also had best oxygenation indexes, with statistical difference in all analyzed variables, and lower frequency of hypoxemia (P=0.03). CONCLUSION:Higher levels of positive end-expiratory pressure in immediate postoperative period of coronary artery bypass grafting improved pulmonary compliance values and increased oxygenation indexes, resulting in lower frequency of hypoxemia.
RCT Entities:
OBJECTIVE: To compare the effects of different levels of positive end-expiratory pressure on respiratory mechanics and oxygenation indexes in the immediate postoperative period of coronary artery bypass grafting. METHODS: Randomized clinical trial in which 136 patients underwent coronary artery bypass grafting between January 2011 and March 2012 were divided into three groups and admitted to mechanical ventilation with different positive end-expiratory pressure levels: Group A, 5 cmH2O (n=44), Group B, 8 cmH2O (n=47) and Group C, 10 cmH2O (n=45). Data about respiratory mechanics were obtained from mechanical ventilator monitor and oxygenation indexes from arterial blood gas samples, collected twenty minutes after intensive care unit admission. Patients with chronic obstructive pulmonary disease and patients submitted to off-pump, emergency or combined operations were not included. For statistical analysis, we used Kruskal-Wallis, G and Chi-square tests, considering results significant when P<0.05. RESULTS: Groups were homogeneous in terms of demographic, clinical and surgical variables. Patients ventilated with positive end-expiratory pressure of 10 cmH2O (Group C) had best compliance (P=0.04) and airway resistance values, this, however, without statistical significance. They also had best oxygenation indexes, with statistical difference in all analyzed variables, and lower frequency of hypoxemia (P=0.03). CONCLUSION: Higher levels of positive end-expiratory pressure in immediate postoperative period of coronary artery bypass grafting improved pulmonary compliance values and increased oxygenation indexes, resulting in lower frequency of hypoxemia.
Authors: André Luiz Lisboa Cordeiro; Caroline Aparecida Gruska; Pâmella Ysla; Amanda Queiroz; Sarah Carvalho de Oliveira Nogueira; Maria Clara Leite; Bruno Freitas; André Raimundo Guimarães Journal: Braz J Cardiovasc Surg Date: 2017 Jul-Aug
Authors: Ary Serpa Neto; Roberto Rabello Filho; Thomas Cherpanath; Rogier Determann; Dave A Dongelmans; Frederique Paulus; Pieter Roel Tuinman; Paolo Pelosi; Marcelo Gama de Abreu; Marcus J Schultz Journal: Ann Intensive Care Date: 2016-11-03 Impact factor: 6.925
Authors: Anna Geke Algera; Luigi Pisani; Dennis C J Bergmans; Sylvia den Boer; Corianne A J de Borgie; Frank H Bosch; Karina Bruin; Thomas G Cherpanath; Rogier M Determann; Arjen M Dondorp; Dave A Dongelmans; Henrik Endeman; Jasper J Haringman; Janneke Horn; Nicole P Juffermans; David M van Meenen; Nardo J van der Meer; Maruschka P Merkus; Hazra S Moeniralam; Ilse Purmer; Pieter Roel Tuinman; Mathilde Slabbekoorn; Peter E Spronk; Alexander P J Vlaar; Marcelo Gama de Abreu; Paolo Pelosi; Ary Serpa Neto; Marcus J Schultz; Frederique Paulus Journal: Trials Date: 2018-05-09 Impact factor: 2.279
Authors: Tommaso Pettenuzzo; Annalisa Boscolo; Alessandro De Cassai; Nicolò Sella; Francesco Zarantonello; Paolo Persona; Laura Pasin; Giovanni Landoni; Paolo Navalesi Journal: Crit Care Date: 2021-07-15 Impact factor: 9.097
Authors: Vanessa Marques Ferreira Méndez; Mayron F Oliveira; Adriana do Nascimento Baião; Patrícia Andrade Xavier; Carlos Gun; Priscila A Sperandio; Iracema I K Umeda Journal: Arch Physiother Date: 2017-01-11
Authors: André Luiz Lisboa Cordeiro; Sarah Carvalho; Maria Clara Leite; André Vila-Flor; Bruno Freitas; Lucas Sousa; Quetla Oliveira; André Raimundo Guimarães Journal: Braz J Cardiovasc Surg Date: 2019-12-01