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Continuous positive airway pressure does not improve lung function after cardiac surgery
Ece Altmay1, Pelin Karaca, Nurgül Yurtseven
1Department of Anesthesiology and Reanimation, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|September 9, 2006
Summary
Continuous positive airway pressure (CPAP) during cardiopulmonary bypass improved oxygenation during surgery but did not enhance postoperative lung function in patients undergoing cardiac surgery.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Anesthesiology
Background:
- Cardiopulmonary bypass often impairs pulmonary function.
- Optimal management strategies for post-bypass pulmonary dysfunction remain debated.
Purpose of the Study:
- To assess the impact of continuous positive airway pressure (CPAP) during cardiopulmonary bypass on respiratory and hemodynamic variables.
- To evaluate the efficacy of CPAP in mitigating pulmonary complications after cardiac surgery.
Main Methods:
- A randomized controlled trial involving 120 male patients aged 45-70 undergoing elective bypass surgery.
- Patients received either 10 cm H2O CPAP during bypass or served as controls (lungs vented to atmosphere).
Main Results:
- CPAP group showed significantly lower alveolar-arterial oxygen difference and shunt fraction post-bypass and post-sternal closure compared to controls (P < 0.05).
- No significant differences in hemodynamic variables were observed between groups.
- Postoperative pulmonary function was reduced in both groups compared to baseline.
Conclusions:
- CPAP during cardiopulmonary bypass transiently improved oxygenation markers but did not lead to sustained improvements in lung function postoperatively.
- In patients with normal preoperative pulmonary function, 10 cm H2O CPAP does not improve lung function after cardiac surgery.
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