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Non-invasive ventilation in cardiac surgery: a concise review
L Cabrini1, V P Plumari1, L Nobile1
1Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milan, Italy.
Heart, Lung and Vessels
|December 24, 2013
Summary
Non-invasive ventilation shows promise for managing respiratory issues before and after cardiac surgery. While not recommended for routine prevention, it can effectively treat acute respiratory failure, though more data is needed.
Area of Science:
- Cardiology
- Pulmonology
- Critical Care Medicine
Background:
- Post-cardiac surgery respiratory dysfunction is common, leading to longer hospital stays and reduced survival.
- Non-invasive ventilation (NIV) offers potential benefits for pulmonary and cardiovascular systems in high-risk cardiac surgery patients.
Purpose of the Study:
- To review current data on the application of non-invasive ventilation (NIV) before and after cardiac surgery.
- To evaluate NIV's role in preventing and treating postoperative acute respiratory failure and aiding mechanical ventilation weaning.
Main Methods:
- A narrative concise review of existing literature on NIV use in cardiac surgery.
- Analysis of data regarding NIV's efficacy, safety, and application in various perioperative scenarios.
Main Results:
- Limited but encouraging data suggest NIV can prevent pneumonia by resolving atelectasis.
- NIV for treating established postoperative acute respiratory failure shows variable success rates (10-55%) with preserved safety.
- NIV has been used in specific cases like percutaneous aortic valve implantation for patients with severe orthopnea.
Conclusions:
- Non-invasive ventilation holds significant potential for perioperative respiratory management in cardiac surgery.
- Current evidence is promising but limited, underscoring the need for further research.
- Optimal outcomes and complication avoidance with NIV require specialized training and experience.
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