PMID: 15242032Jul 10, 2004Paper

Effect of respiratory care on pulmonary function in patients after cardiopulmonary bypass

Masui. The Japanese journal of anesthesiology
Kiyoko Inoue

Abstract

Respiratory failure after cardiopulmonary bypass (CPB) remains one of the major complications after cardiac surgery. This study was designed to evaluate effects of respiratory care after CPB on pulmonary function. Eighteen patients scheduled for cardiac surgery were investigated. Preoperative respiratory functions (%VC, FEV1.0%, V25/Ht, FRC-CC, deltaN2) were measured in all the patients. Both induction and maintenance of anesthesia were performed using propofol, midazolam, fentanyl, and vecuronium bromide. All the patients were ventilated using volume controlled ventilation by setting FIO2 at 0.5, the respiratory frequency at 15 x min(-1), the tidal volume at 6-10 ml x kg(-1) adjusted to maintain PaCO2 between 30 to 40 mmHg, and the peak airway pressures below 40 cmH2O, PEEP of 0 cmH2O. From 1 hour after the operation, the patients were randomly divided into 2 groups: group A, ventilated artificially with PEEP of 5 cmH2O and group B, ventilated with PEEP adjusted to the patient's lower inflection point (LIP) obtained by the pressure-volume curve. PaO2, Qs/Qt and FRC were measured after induction of anesthesia, just after surgery, 1 hour after surgery and 1 hour after artificial ventilation with PEEP. The values of the LIP were ...Continue Reading

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